Local Anesthesia During Operations on the Cervix, Vagina, and Vulva

Abstract

Introduction. Operations under general anesthesia carry risks to the patient’s health, require appropriate equipment of the operating room, additional personnel in the team. This was the impetus for the active dissemination of local anesthesia technologies in the obstetric and gynecological community. The purpose of the study is to determine the current state of the issue of the use of local anesthesia in gynecology in outpatient settings during operations on the cervix, vagina and vulva.Materials and methods. Publications freely available from databases were used to prepare the work еLibrary.Ru, PubMed, in Russian and foreign specialized journals on obstetrics and gynecology, anesthesiology, textbooks, the predominant period of publication 2016–2023.Results and discussion. In the XIX century, scientists actively worked on the issue of finding an effective anesthetic and a method of anesthesia, the XX century shows that research continued in the direction of identifying the safest drug for anesthesia. In the XXI century, an obstetrician-gynecologist has a huge arsenal of anesthesia techniques, in which it is enough only to choose those techniques that can be used effectively, safely and financially affordable in his medical institution. The literature review shows the high efficiency of infiltration anesthesia during cervical biopsy, excision and conization, as well as a reduction in the number of complications associated with anesthesia. At the same time, for a small volume cervical biopsy, application anesthesia (10% lidocaine aerosol) can be used, but for conization with curettage of the cervical canal (and maybe even with aspiration biopsy), regional anesthesia (paracervical blockade) can be used — the technique of which is described in detail. Local anesthesia of the vagina can be performed using both infiltrative and application anesthesia. Local anesthesia of the vulva is replete with information about the widespread use, effectiveness and safety of application methods of anesthesia, not only in diagnosis, but also for the purpose of treatment.Conclusion. Despite the wide variety of techniques of local anesthesia, as well as the exclusion of adverse events associated with anesthesia, any obstetrician-gynecologist should understand that local anesthesia can also lead to various complications, and be ready to eliminate them.