Xylocaine W/ Adrenaline Use In Pregnancy & Lactation

Use in pregnancy: The safe use of lignocaine during pregnancy has not been established. Although lignocaine has been used extensively for surgical procedures during pregnancy with no reports of ill effects to mother or foetus, there are no adequate or well-controlled studies in pregnant women of the effect of lignocaine on the developing foetus.
Lignocaine has been effectively used for obstetrical analgesia and adverse effects on the course of labour or delivery are rare. After epidural administration of lignocaine to women in labour, lignocaine crosses the placental barrier. However, concentrations in umbilical veins are lower than those found in the maternal circulation. It has been suggested that blood glucose levels should be checked in newborns after obstetric regional anaesthesia.
Adrenaline has been given to a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other indirect harmful effects on the foetus having been observed.
The addition of adrenaline may potentially decrease uterine blood flow and contractility, especially after inadvertent injection into maternal blood vessels.
Adrenaline may delay the 2nd stage of labour by inhibiting uterine contractions.
Adrenaline-free solutions should be used during labour for paracervical or pudendal blocks.
Note: Paracervical blocks may be associated with foetal bradycardia (see previous text).
Use in lactation: Lignocaine passes into breast milk. The amount of lignocaine appearing in breast milk from a nursing mother receiving parenteral lignocaine is unlikely to lead to a significant accumulation of the parent drug in the breastfed infant. The remote possibility of an idiosyncratic or allergic reaction in the breastfed infant from lignocaine remains to be determined.