Local anesthesia during pregnancy - you should know that
Local anesthesia during pregnancy can pose risks. However, there are also medications that are less harmless. In this practical tip, you will learn which these are, how you take them and what risks are involved.
Risks of local anesthesia in pregnancy
Local anesthesia has certain risks that can adversely affect the unborn child. We have summarized what local anesthetics are and what risks they pose:
- Anesthetics of the acid amide type inhibit the conduction of stimuli on the nerve fibers by blocking voltage-dependent sodium channels.
- Many of the anesthetics cross the placenta, which transfers a certain percentage of the mother's values to the fetus. For this reason, the anesthetics should have a high plasma protein binding so that less passes through the placenta.
- Some agents reduce membrane permeability to sodium. This leads to a reduced excitability of nerve fibers.
- Procaine, for example, carries a high risk of methaemoglobin formation, which is why it should not be used.
- Lidocaine is safe while breastfeeding, but is too risky during pregnancy. It transfers about 60 percent of the values to the baby.
- Anesthetics may be used in combination with adrenaline, but the proportion of adrenaline may not exceed 1: 200, 000. Otherwise, uterine contractions can occur, causing miscarriage .
- The active ingredient can cause poisoning in babies if it crosses the placenta. Since your protein binding is half that of pregnant women, the risk is significantly higher.
Unproblematic local anesthetics
However, there are some active ingredients that are safe for the pregnant woman and her child if they are administered correctly. Here, too, the adrenaline content should not be too high and the placental protein binding should be at least 90 percent.
- Articaine: This remedy is often used by dentists. The placental barrier can pass to a small extent. About a third of the mother's values are achieved. Prophylactic dental treatment is recommended for pregnant women from the second trimester. Protein binding is 94 percent and is a preferred agent.
- Bupivacaine: Often used in obstetrics, this anesthetic has a strong effect with a long duration. However, there is a high risk of toxic side effects. Since only a quarter to a third of the values are transferred to the child, this means has the least placental activity.
- Ropivacaine: The effectiveness is comparable to that of bupivacaine, but with a lower risk of toxic side effects. This remedy can also cross the placental barrier.
- Etidocaine: Is also a safe active substance during pregnancy and behaves similarly to articaine. The time of action can last up to eight hours, making it one of the slow-acting local anesthetics.
Not only medication can become problematic during pregnancy. Foodstuffs such as poppy seeds or menthol also harbor risks.