Local anesthesia at the ear
Although anaesthesia should always be carefully considered during pregnancy, there are situations in which local anaesthesia is absolutely necessary. These include injuries that require stitches or urgent dental operations that cannot be postponed until after delivery. (see: Local anaesthesia in dentistry) Even though local anaesthesia is considered very safe and low-risk for the unborn child, there are some specifics that should be considered in order to minimize the risk for the child.
In any case, it is important to inform the attending physician about the pregnancy so that he or she can take these particularities into account. Surgery under local anesthesia can be performed at any time during pregnancy. In contrast, general anesthesia should not be used during the first months of pregnancy.
There are, however, differences in the choice of anaesthetic medication compared to non-pregnant women. The usual medications (= anaesthetics) are very fat-soluble and can easily enter the child’s circulation via the umbilical cord, but larger amounts should enter the bloodstream during local anaesthesia, which is not actually intended. In this case, anaesthetics should be chosen which are not so easily fat-soluble and, if necessary, should not enter the child’s circulation, since anaesthetics should enter the bloodstream.
Normally, drugs are added to the drugs which cause the vessels to become narrow. This is to prevent excessive spreading of the drug and major bleeding. In this case, adrenaline derivatives should be used during pregnancy, as some other substances can promote contractions.
However, if all these special features are taken into account, there is usually nothing to prevent operations under local anesthesia. If there is still a great deal of fear of such operations, sedatives can also be used. Benzodiazepines such as diazepam have proved to be particularly suitable and can also be used for a short time during pregnancy in good conscience to reduce the stress reactions of the expectant mother, which are also felt by the child.