Paracervical Block With Combined Ketorolac and Lidocaine for Osmotic Dilator Placement

Exclusion Criteria

• •Have taken NSAIDs less than 6 hours prior to their clinic visit
• •Contraindications to lidocaine such as allergy to lidocaine, cardiac arrhythmia or heart block, and porphyria
• •Allergic reaction or sensitivity to NSAIDs
• •History of peptic ulcer or gastrointestinal bleed, history of gastric bypass (RYGB) or recent history in last 6 months of gastric sleeve; history of inflammatory bowel disease (Ulcerative colitis, Crohn's disease)
• •Uncontrolled hypertension, heart failure, ischemic heart disease, peripheral arterial disease, cerebrovascular disease
• •Acute renal failure or chronic renal disease
• •Chronic liver disease
• •History of bleeding diathesis
• •Untreated acute cervicitis or pelvic inflammatory disease
• •Require or request IV sedation for placement of osmotic dilators
• •Require more than 1 day of osmotic dilators
• •Chronic or current narcotic use
• •Current recreational drug use (excluding cannabis)