Local anesthetics in pregnancy

Local anesthetics are generally used for minor, outpatient procedures, examples being biopsies or dental procedures. Since only a small amount of the drug is applied locally, the chance of systemic effects is small and therefore an effect of the local anesthetic on the baby is unlikely. Also a study from 1977 with lidocaine did not show an increased rate of malformations. Local anaesthetics can therefore also be used during pregnancy.

Duration

The duration of local anesthesia depends on the anesthetic used. Both the onset and duration of action can vary between the medications. Lidocaine, for example, lasts one to two hours, while bupivacaine can last up to 5 hours. It is best to ask your doctor before the procedure how long you can expect the local anesthetic to work.

ContraindicationsCounter indications

There are relatively few contraindications for the local application of local anesthetics, as the drugs usually have hardly any systemic effect with this type of application.Important contraindications for the use of local anesthetics are already known allergies to the active substance, inflammations in the area of application, since efficacy is not certain there, and an increased tendency to bleed, for example due to treatment with blood thinners (anticoagulants). However, this is not related to the drugs themselves, but to their application and is particularly true for anaesthesia procedures close to the spinal cord, such as spinal or epidural anaesthesia, since bleeding caused by inserting the cannula can cause great damage. Pregnancy and lactation are not a general contraindication, but the indication should be strictly defined.

The use of local anaesthetics in infants should only be used in urgent cases. Even in cases of severe cardiac arrhythmia and heart failure, the use of local anesthetics should be carefully considered. An allergy to a local anaesthetic can lead to various symptoms.

On the one hand, rather harmless local reactions such as redness, itching or skin rashes can occur, and on the other hand, severe systemic reactions such as a drop in blood pressure or anaphylactic shock can be life-threatening. However, such severe reactions are very rare. Skin tests can be used to determine whether an allergy to a particular drug is present and accordingly other local anesthetics or other anesthetic methods can be considered.