During the critical period of pregnancy, physicians must exercise heightened caution when prescribing medications, meticulously verifying their safety due to the risk of fetotoxicity which can lead to severe health complications or even be fatal to the developing fetus. However, it’s crucial to recognize that among the myriad of drugs that require restriction or avoidance, certain medications have been classified as safe for use during pregnancy. Lidocaine is one such drug, which, under medical supervision, has been deemed safe for both the mother and fetus when used in proper doses.
Lidocaine, a local anesthetic, is often utilized in various medical scenarios including dental procedures, minor surgical interventions, and particularly in obstetrics for episiotomies or as an anesthetic during a cesarean section. Its safety profile during pregnancy is well-supported by clinical research, which shows that when administered judiciously, lidocaine does not significantly cross the placental barrier to harm the fetus. This makes it a valuable option for pain management in pregnant women, where the benefits to the mother’s comfort and stress levels can indirectly benefit fetal health as well.
Let us explore the relationship between lidocaine and pregnancy and evaluate the drug in terms of its usefulness during as well as at the end of the gestation period.
What is lidocaine?
Lidocaine is an FDA-approved local anesthetic as well as an antiarrhythmic drug, employed topically or injected intravenously, which is extensively used in minor dental as well as surgical procedures. The drug is marketed under the brand names Lidoderm, Xylocaine, AnaMantle, and Emla.
Clinical applications of lidocaine
Lidocaine is being used in the following clinical conditions:
– Lidocaine finds application as a local anesthetic employed to cause numbness of the skin during procedures such as sigmoidoscopy, removal of ingrown toenails, etc.
– Topically, lidocaine-incorporated creams are used to stop the itching sensation on the skin. It is also useful to treat pain caused due to minor burns, eczema, hemorrhoids, insect bites, or scrapes.
– Lidocaine is also utilized to manage conditions related to genital or anal areas in order to relieve itching and discomfort.
Use of lidocaine during pregnancy
Lidocaine, due to being considered safe for use in pregnant women, has been widely administered. It falls into the FDA pregnancy category B which means ‘no proven risk in humans’. However, if its concentration exceeds the normal dose, infants born to these mothers have been noticed to show side effects owing to the fact that the drug has an easy crossing through the placental barrier. The drug is used in the following cases in pregnant women:
– Buccal use
According to the data published by the National Maternal and Child Oral Health Resource Center, it is safe to use lidocaine in pregnant women who are in their third trimester with a simple precaution i.e. the exposure to lidocaine should not exceed a duration of 3 hours.
– Topical use
Although topical use of lidocaine in pregnant subjects has not been studied, it has been established from animal models that the drug does not pose any serious health risk. However, there is a need to conduct studies to confirm these claims.
– Intravenous use
Lidocaine IV solution is administered to the patients to treat the abnormal rhythmic activity of the heart. It is generally considered safe to inject an IV solution of lidocaine into a pregnant patient. It should be made sure that the drug solution does not have any additional ingredients in it such as salicylates i.e. choline salicylate which could cause harm.
– Epidural use
Lidocaine, in 1% concentration, is used as lumbar epidural analgesia. Due to its use, stages of labor are not prolonged. Moreover, the chances of cesarean or vacuum-assisted delivery are not elevated.
Potential side effects of lidocaine
Lidocaine can cause the following side effects:
– Nausea
– Vomiting
– Unusual thirst
– Weakness
– Fatigue
– Redness, blisters, and rashes after topical application
– Blurred vision
– Low blood pressure
– Ringing in the ears
– Slurred speech
Warning: In case of any of the above-mentioned side effects after lidocaine use, one should immediately contact their healthcare provider for further advice.
FAQs about Lidocaine and pregnancy
If utilizing lidocaine during pregnancy is a concern for you, in this section you’ll find answers to the most frequently asked questions regarding the safety of using lidocaine during pregnancy:
Does lidocaine affect the infant when used at the time of delivery?
Based on the findings of some case reports, it has been noticed that lidocaine, when administered to mothers at the time of delivery, causes some side effects in their infants. These include dilated pupils, difficulty in breathing, low muscle tone, or, in the worst case, seizures. Although these effects do not pose major health risks, it is safe to say that lidocaine can be used at delivery time.
Can lidocaine increase the risk of birth defects?
No. According to the published literature, infants born to mothers who were given lidocaine during their pregnancy do not have a higher-than-usual risk of having birth defects. Similar findings have been obtained when lidocaine was administered to animal models followed by an evaluation based on its effects on the offspring.
Does lidocaine have an effect on fertility?
No, lidocaine does not affect fertility, in both female and male subjects, neither does it enhance the chances of miscarriage.
Is it safe to breastfeed while being on lidocaine?
Yes. Despite the well-known fact that lidocaine can seep into the infant’s body through the mother’s milk, no side effects have been observed owing to the poor drug absorption in the babies. It is still preferable to discuss with your healthcare provider before taking lidocaine if you are breastfeeding.
Conclusion
Pregnancy is a state in which special focus is given to what is being administered to the mother when it comes to drugs. Lidocaine is a synthetic drug that is commonly used for minor health issues as well as a local anesthetic. Reported data by health organizations have indicated that the drug is safe to be used in pregnant women, as it does not cause any significant side effects in infants.
Moreover, lidocaine has also been found to be ineffective on a patient’s fertility, miscarriage rates, and incidences of birth defects, which further strengthens its position on the safety spectrum. In summary, lidocaine is totally safe when used in accordance with the advice of your healthcare provider.
PhD Scholar (Pharmaceutics), MPhil (Pharmaceutics), Pharm D, B. Sc.
Uzma Zafar is a dedicated and highly motivated pharmaceutical professional currently pursuing her PhD in Pharmaceutics at the Punjab University College of Pharmacy, University of the Punjab. With a comprehensive academic and research background, Uzma has consistently excelled in her studies, securing first division throughout her educational journey.
Uzma’s passion for the pharmaceutical field is evident from her active engagement during her Doctor of Pharmacy (Pharm.D) program, where she not only mastered industrial techniques and clinical case studies but also delved into marketing strategies and management skills.
