Local and regional anaesthesia: paracervical block risk: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Local and regional anaesthesia: paracervical block risk

Sample item

A paracervical block with bupivacaine is given for pain in the first stage of labour. Which fetal complication is characteristic?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Fetal bradycardia

Injection near the uterine arteries leads to high local anaesthetic levels reaching the fetus and may reduce uterine blood flow, so fetal bradycardia occurs in a notable proportion of cases. Because of this it is rarely used with a fetus already at risk, and fetal heart monitoring is essential.

Option by option

  • A. Fetal tachycardia with hypertonia

    Tachycardia is not the typical response to this block.

  • B. Fetal hyperglycaemia

    Hyperglycaemia is not an effect of paracervical local anaesthetic.

  • C. Fetal opioid-type respiratory depression

    The drug used is a local anaesthetic, not an opioid, so opioid effects do not apply.

  • D. Fetal bradycardia (correct)

    Correct. Uterine artery uptake and reduced flow give fetal bradycardia, the known hazard.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Fetal bradycardia. Injection near the uterine arteries leads to high local anaesthetic levels reaching the fetus and may reduce uterine blood flow, so fetal bradycardia occurs in a notable proportion of cases.

Why is "Fetal tachycardia with hypertonia" not the answer?

Tachycardia is not the typical response to this block.

Why is "Fetal hyperglycaemia" not the answer?

Hyperglycaemia is not an effect of paracervical local anaesthetic.

Why is "Fetal opioid-type respiratory depression" not the answer?

The drug used is a local anaesthetic, not an opioid, so opioid effects do not apply.

What concept does this question test?

It tests Local and regional anaesthesia: paracervical block risk in Anaesthesia. Because of this it is rarely used with a fetus already at risk, and fetal heart monitoring is essential.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local and regional anaesthesia: paracervical block risk?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.