Local anesthesia during early pregnancy. How dangerous is anesthesia during pregnancy? When and how to treat teeth

Anesthesia or, in medical terms, anesthesia is an indispensable part of any surgical operation. As a rule, at least once in a lifetime, but a person experiences the effect of anesthesia on himself, even if it is of a local nature. Rarely, but still, the need for anesthesia may arise during the period of bearing a child. In this case, quite a natural question of the safety of anesthesia for the expectant mother and her fetus often arises. Does anesthesia affect the state of the body of the expectant mother and the fetus? And if it does, how?

According to statistics, the need for anesthesia occurs in about two percent of pregnancies. Factors such as surgical operations in the field of traumatology, surgery (appendectomy or cholecystectomy), in dentistry may be inclined to this.

Surgical intervention during pregnancy can be performed only with a high level of threat to the life of the mother. With a woman's health that is not so serious, surgical interventions are postponed until the time after childbirth.

Turning to the statistical data again, analyzing them, medicine came to the following conclusions:

among pregnant women who underwent surgical interventions with anesthesia during the period of bearing a baby, extremely low mortality;
the risk of developing anomalies in a child is also extremely low when the mother undergoes anesthesia during pregnancy;
the probability of miscarriage after undergoing anesthesia by the expectant mother is equal to six percent of the total amount of anesthesia during pregnancy, and this figure has been increased to eleven percent in cases of anesthesia in the first trimester of pregnancy, and this especially applies to the first eight weeks of the term;
the risk of preterm birth during anesthesia during pregnancy is approximately eight percent of the total number of cases.

Numerous studies confirm the safety of anesthetics used during childbearing. Even the negative effects of ancient and dangerous anesthetics such as diazepam and nitrous oxide are now being questioned by the leading surgeons of world medicine.

An important role in anesthesia during pregnancy is played not by the choice of the drug, but by the method of its introduction into the mother's body, that is, the technique of anesthesia. When conducting anesthesia during surgery, it is very important to prevent a woman in a position from lowering the level of blood pressure and saturating her blood with oxygen.

Accidental release of adrenaline into a blood vessel can cause disturbances in the mother's blood flow to the placenta, which, in turn, will negatively affect the supply of oxygen to the fetus. Therefore, many doctors do not recommend the use of local anesthetics containing adrenaline during pregnancy, such as ultracaine.

From all of the above, we can conclude that anesthesia as such during pregnancy does not cause much harm to either the body of the expectant mother or her fetus, and is a fairly safe measure. But, anesthesia with adrenaline can adversely affect the development of a child inside the womb, especially in the first trimester of pregnancy, during the development and formation of organs and systems of the fetus.

Therefore, the decision on anesthesia during pregnancy should be appropriate and taken only collectively, taking into account the possible negative impact on the fetus.

If the condition of the future mother is sufficiently tolerable, and allows you to postpone surgery, it is best to decide on anesthesia in the period after the birth of the child. In extreme cases, it is better to postpone the operation with anesthesia until the third trimester.

If the question arises about the type of anesthesia, then it is preferable to perform an operation under local anesthesia during the period of bearing a baby. If local anesthesia is not possible, regional anesthesia is an alternative. If these two types of anesthesia are not possible, the woman is operated on under general anesthesia. For any type of operation with anesthesia, a specialist gynecologist must be present, who will tirelessly monitor the condition of the fetus. And if necessary, when the operation is delayed and there is a threat of premature birth, it will be carried out in order to save the life of both the mother and the child.

None of us is immune from health problems, and expectant mothers often worry about this kind of trouble. Particularly serious diseases sometimes require urgent surgical intervention, which causes a lot of questions and worries, since treatment, especially anesthesia, is not particularly desirable during pregnancy. But it is not worth delaying the operation, if it is urgent and urgent. Here you are, as they say, a double-edged sword.

The mother's body during pregnancy works in a special mode, the composition of the blood changes, the load on all organ systems increases. Chronic diseases can worsen and go to the stage when urgent surgery is required. Also, the help of a surgeon may be needed in case of an unforeseen injury or dental problem. Therefore, doctors must be extremely careful not to harm either the mother or the child, their work is only equivalent to jewelry.

At what stage of pregnancy is anesthesia safest for the unborn child?

During the operation, the responsibility lies not only with the surgeon, but also with the anesthesiologist, he needs to very accurately calculate the dose of anesthesia, taking into account the gestational age, fetal sensitivity, placental permeability, and possible consequences. An incorrectly selected dose of anesthesia during pregnancy can cause violations in the development of the child, its metabolism, in especially severe cases, provoke deformity or death of the baby. A particularly dangerous period for the introduction of anesthesia is 2-8 weeks inclusive. From week 28 until the end of the gestation period, the threat is also increased. If surgical intervention is necessary and there is an opportunity to drag out time, then doctors recommend the period from 14 to 28 weeks for operations, at which time the uterus does not react so strongly to external influences, and the main organs of the baby are already formed.

What types of anesthesia are acceptable for pregnant women

The most suitable for safety is the method of regional anesthesia. In this case, anesthesia is administered over the membrane of the spinal cord, while the mother remains conscious, the lower part of the body becomes anesthetized. But options are not excluded when there are contraindications to such a method, for example, neurological diseases, or it cannot be applied due to the duration of the operation. Therefore, doctors have to use multicomponent balanced anesthesia, while artificial ventilation is needed. Before the operation, it is necessary to prescribe drugs that help reduce the acidity of gastric juice so that vomiting does not occur.

The drugs used for anesthesia will depend on your timing, condition and complexity of the operation. For small operations, Lidocaine is usually used, which provides local anesthesia, it breaks down rather quickly and does not have time to harm the fetus. Ketamine is prescribed for intravenous anesthesia, but it is used in small doses and carefully, since it is able to increase the tone of the uterus, but in the third trimester its negative effect becomes more weakened. Nitrous oxide is used in combined anesthesia, but very rarely and for a short time, this drug is harmful to a small organism. If the expectant mother suffers from severe pain, then Morphine or Promedol can be used for injections, they are the least dangerous and almost do not cause malformations in the child. Of course, you must be extremely careful and prevent the occurrence of such health situations. If the inevitable happened, then you should trust only experienced and qualified specialists.

Medical statistics show that 2% of pregnant women need to perform certain surgical interventions associated with acute diseases, injuries or the need for dental treatment. In some cases, anesthesia is used to eliminate pain, in others local anesthesia is done, the choice is made individually in each case.

When is anesthesia used during pregnancy?

Unfortunately, the happy state of expecting a baby in some pregnant women is overshadowed by the development of acute diseases that require urgent surgery and, of course, anesthesia. It is well known that any operation and anesthesia contain a certain amount of risk for the average patient. During pregnancy, this risk increases - both for the fetus and for the woman herself.

And yet, despite all the risks, the doctor is obliged to choose the lesser of two evils, because in any case, anesthesia during pregnancy is associated with operations that are performed according to vital indications in cases:

acute appendicitis;
acute cholecystitis;
peritonitis;
intestinal obstruction;
bleeding of various etiologies;
acute gynecological pathology (ovarian cyst torsion);
injuries of the abdominal and thoracic cavities;
development of abscesses, phlegmon, purulent pleurisy.

Sometimes general anesthesia can be used for various manipulations and diagnostic procedures. For example, in the case of esophageal-gastric bleeding, gastroscopy is performed under anesthesia.

It is extremely rare that anesthesia is used in dental practice. In the vast majority of cases, dental anesthesia in pregnant women is performed using local technology.

Advice: in the event of a pain syndrome or injuries, pregnant women should not take any analgesics, sedatives, hypnotics on their own without the knowledge of a doctor. They can "erase" the manifestations of the disease, as well as have a negative effect on the fetus. In these cases, you should immediately consult a doctor.

How anesthesia affects the body of the mother and fetus

It is quite true to say that there are no harmless medicines, or, as they say in everyday life, one medicine heals and another cripples. This is true for anesthesia as well. General anesthesia affects the nervous, vascular, respiratory and endocrine systems, metabolism, liver and kidney function.

But the question is that such anesthesia is nothing but a vital necessity, and it is carried out in pregnant women only during operations that have vital indications. Here, as they say, there is nowhere to go, and the choice is clear. In principle, modern technologies prevent any serious and long-term effects of anesthesia on the body, and it is quickly cleared and restored.

As for the unborn child in the mother's womb, anesthesia poses a much greater danger to him, especially in the early stages. Any negative effects in the first trimester, including narcotic, sedatives, analgesics, can affect the formation of fetal organs and subsequently various congenital anomalies may form.

At later stages of pregnancy, that is, after 3 months, the fetus is already fully formed, that is, it is already a real little man with the functioning of all organs and systems. At these times, anomalies can not be feared, however, the consequences may manifest themselves in the form of hypoxia, developmental delay.

Advice: as soon as a situation has arisen when an operation is necessary under anesthesia in a pregnant woman, one must overcome all fears and realize that this choice is made in the name of saving life, and the possible consequences of anesthesia in this case are secondary. Moreover, modern anesthesia technologies are more gentle, and it is possible to eliminate negative consequences.

How is the choice of anesthesia during pregnancy

The main principle of pain relief during pregnancy is to maximize the possibilities of local anesthesia. The best option for both the mother and her unborn baby is epidural anesthesia - the introduction of an anesthetic around the hard shell of the spinal cord. This method does not give a pronounced general intoxication, but only temporary side effects occur in the form of nausea, pressure changes, and so on.

When there is a question of serious abdominal interventions, when muscle relaxation is necessary, anesthesia is used. There are many types of it - mask, intravenous, intubation. Various narcotic substances are used - nitrous oxide, halothane, calypsol. For pregnant women, anesthesia is selected individually - neuroleptanalgesia with drugs that do not affect the tone of the uterus, do not disturb the blood circulation of the placenta.

An example of such a drug is calypsol, which is used for short-term intravenous anesthesia, and is subsequently rapidly excreted from the body. In any case, the choice of anesthetics, their combination is selected individually, depending on the nature and duration of the upcoming operation.

In dentistry, if urgent dental treatment is needed in pregnant women, anesthesia is used extremely rarely, local anesthetics are used - lidocaine, ultracaine and others.

Anesthesia during pregnancy is dictated by the need for life-saving interventions. Qualified performed by specialists, it does not carry dangerous consequences for the body.

Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for self-treatment. Be sure to consult a doctor!

Medical statistics show that in 2% of expectant mothers there is a need for surgical interventions with the use of anesthesia. More often these are operations in dentistry in the treatment of teeth, general surgery (during appendectomy, cholecystectomy) and traumatology. Pregnant women are worried about their teeth, there are also injuries that can only be dealt with with the help of surgery and anesthesia. And although 2% of statistics is a low figure, any woman who is preparing to become a mother can fall into this number. Therefore, it would be useful to find out if anesthesia is dangerous during pregnancy, what types of anesthesia are used and what drugs are used during this period.

General anesthesia during pregnancy

To date, there are no absolutely harmless anesthetic drugs. All drugs in this category have their own toxicity threshold. It can be high and low, and according to this criterion, the admissibility of their use during pregnancy is determined. The threshold of toxicity also depends on the dose of the anesthetic drug. It is calculated in each case during the operation by the anesthesiologist. A properly selected dose of anesthetic allows you to put the patient to sleep, relax all the muscles of the body, make her insensitive to pain for the period of the surgical intervention. At the end of the anesthesia, the patient "wakes up".

Pregnant women should be aware that in the first and second trimesters of the term, anesthetic drugs pose a higher danger to the baby than to the mother. Especially if they are used in the early stages up to 8 weeks of pregnancy. Indeed, during this period, the main organs of the child are formed. And anesthetics penetrate the placenta, inhibit the development of cells. Thus, the risk of congenital malformations increases. Doctors call it a teratogenic effect. Therefore, at this time, general anesthesia is not used, and if it is possible to avoid the operation or postpone it to a later date, then this is exactly what they do.

Most painkillers that are used during surgical interventions have a low threshold of toxicity. It is also worth noting that it is not the drug itself that plays a big role in the subsequent development of deviations, but the technique of general anesthesia. It is important to prevent a rapid drop in blood pressure and oxygen levels during the operation.

For general anesthesia in pregnant women, different drugs are used. Does not harm the fetus and mother Promedol, Morphine and Glycopyrolate in minimal doses. Ketamine is used for intravenous anesthesia. But this remedy with prolonged use increases the tone of the uterus.

Often, expectant mothers need to relieve acute pain, for example, a toothache. Is it possible to carry out anesthesia with tablets in this case? Experts say that you can resort to them only in extreme cases. Non-hazardous drugs for pregnant women are Ibuprofen and Paracetamol. Other anesthetics are prohibited.

What anesthesia is used during the gestation period

If possible, the expectant mother is given epidural (regional) anesthesia. If this type of anesthesia cannot be used, then a multicomponent balanced anesthesia with artificial lung ventilation is performed. In this case, a special tube is inserted into the trachea.

Epidural anesthesia is the safest method of pain relief for the expectant mother and fetus. To conduct it, a needle is inserted through the hole in the spinal canal. The insertion zone is called the epidural space. There are nerve roots that carry pain impulses from the uterus. Before inserting the needle, the skin at the injection site is anesthetized. A catheter (silicone tube) is inserted into the needle, through which a local anesthetic is injected. The drug can be added if necessary, thus prolonging the effect of anesthesia up to 36 hours.

The effect of anesthesia after the introduction of the anesthetic occurs after 10-20 minutes. It is worth noting that a woman at the time of insertion of the catheter may feel a shooting in her leg.

After epidural anesthesia, the following complications occur:

Headache. It can occur in a pregnant woman a day after the use of anesthesia.
Skin itching. It occurs purely at the injection site of the needle. Treat if necessary with antihistamines.
Difficulty breathing. This complication develops due to the long stay of the patient on the back. In this case, oxygen is supplied through a special mask.
Dizziness, rapid heartbeat, numbness of the tongue, metallic taste in the mouth. These signs may occur at the time of administration of the anesthetic. To avoid the appearance of such sensations, before the introduction of the full volume of the drug, the woman is given a test dose.

There are a number of contraindications for epidural anesthesia. These are bleeding disorders, sepsis, bleeding, skin infection at the site of catheter insertion, neurological diseases, patient refusal.

If we are talking about simple surgical interventions in the third trimester, then mask anesthesia can be used. In this case, the anesthetic enters the body of the pregnant woman through the respiratory system.

Another type of pain relief is nitrous oxide, which is used by inhalation. That is, again, a mask is used. It is worth noting that this type of anesthesia can harm the development of the baby. But in low concentrations (the ratio of oxygen and nitrogen is 1: 1) and for a short time, this type of anesthesia is still used. A low concentration of nitrogen does not have a negative effect. It induces deep sleep, relaxes the muscles.

Local anesthesia during pregnancy

Most often it is used by the dentist. The non-drug method of pain relief is cooling. A liquid with a low boiling point is applied to a part of the gum. Cooling comes quickly: the nerve fibers lose their sensitivity - and the dentist performs therapeutic manipulations.

Also, dentists can use topical anesthesia for the treatment of pregnant women. In this case, the medicine also does not enter the general circulation. An anesthetic gel is applied to the mucous membrane in the right place. It blocks nerve endings.

For local anesthesia in expectant mothers, the drugs Mepivastezin, Ultracaine and Ultracaine DS are used. The latter is designed specifically for pregnant women and children. It has almost no side effects. Dentists in most cases prefer Ultracain DS. Its advantage is also that it is quickly excreted from the female body. It is equally important that the drug cannot cross the placental barrier. A gentle local anesthetic is Ubistezin with epinephrine - it does not harm the fetus and its mother.

Is anesthesia harmful during pregnancy: consequences, effects on the fetus

So, we recall that operations and anesthesia during the bearing of a baby are performed only for emergency indications, if there is a threat to the life of a woman. If the surgical intervention can be delayed until the birth of the baby, then they do so in order to eliminate the slightest risk of a negative effect on the fetus.

The experts analyzed the practical experience of anesthesia for pregnant women and came to the following conclusions:

Mortality during anesthesia is very low. The number of deaths during pregnancy is the same as in ordinary women.
The probability of miscarriage or fetal death is about 11% if anesthesia was administered to a woman in the first trimester of pregnancy.
The risk of preterm birth after the administration of pain medication is about 8%.

Studies have questioned the negative impact on the fetus of the historically dangerous drugs diazepam and nitrous oxide. There is an opinion that during pregnancy it is necessary to avoid the use of local anesthetics with adrenaline in the composition, because they can cause a violation of blood flow to the placenta.

So, local and general anesthesia during surgical intervention during the period of bearing a baby is quite safe for the health of the mother. But the baby can be significantly harmed if the operations are carried out in the early stages - in the first trimester of pregnancy. Decisions on the advisability of their implementation should be made carefully, taking into account the individual characteristics of the woman's body, the course of her pregnancy.

It is recommended to give preference to local anesthesia whenever possible. If for some reason it cannot be applied, then the choice is made in favor of the epidural. And only if it is not possible to conduct regional anesthesia, surgery is performed under general anesthesia.

The expectant mother should protect herself as much as possible from injuries, avoid traumatic places and fast driving. Even before the onset of an interesting situation, one should think about the state of those organs and systems where surgical intervention may be needed, and undergo an examination in advance, in particular, a medical examination by a dentist).

Take care of yourself, avoid even minimal risks during the period of bearing crumbs!

During the 9 months of pregnancy, anything can happen to a woman. There was a purulent appendicitis, it is necessary to make a tooth implantation, an injury that needs surgical intervention ... Such cases always involve the use of anesthesia. But what if the woman is in position? In this situation, a competent approach and the choice of suitable drugs for anesthesia is necessary. Let's see if anesthesia is possible during pregnancy, when it is impossible to do without it, and how anesthesia is performed in the gestational period.

According to statistics, about 5% of women resort to forced anesthesia while carrying a baby. Therefore, anesthesia in the gestational period is a topical and frequently discussed topic among obstetrician-gynecologists and anesthesiologists. This topic remains no less exciting for expectant mothers.

Speaking about the effect of anesthesia on the female body, it can be unequivocally stated that for him this is a real stress. As a result of artificial entry into sleep, there is a violation of all biochemical processes. Therefore, any surgical intervention under anesthesia in this period is carried out exclusively for health reasons. And any planned operation is almost always postponed until later.

To evaluate how anesthesia affects pregnancy, it is important to consider what type of anesthesia is used, how skilled the anesthesiologist is, and the complexity of the operation itself.

In obstetrics, medical sadation is often used. Under the influence of sedatives, a woman falls into a deep sleep, but the effect on the body is much less than with conventional anesthesia. This minimizes possible complications for both the woman and the fetus. As a rule, such anesthesia is used during pregnancy in the treatment of dental complications, for example, implantation of teeth or opening of the gums with purulent lesions.

Most surgeries are performed with epidural anesthesia., during which the woman is conscious, but does not feel anything. This method is used for operations on internal organs. The disadvantage of anesthesia is the high risk of reactive hypotension.

The drop in pressure adversely affects pregnancy and phytoplacental blood flow is disturbed. Fortunately, professional monitoring of a woman under anesthesia allows you to immediately eliminate this condition, so the fetus does not have time to feel hypoxia.

But, despite the achievements of medicine, the priority remains regional or local anesthesia during pregnancy when only one area is anesthetized. This is acceptable in some cases where the operation will not be very painful, for example, tooth extraction, excision of a boil, reduction of a joint.

However, it is undesirable to use drugs based on adrenaline for local anesthesia, otherwise doctors need to be ready to help a pregnant woman in time if she becomes ill after an injection. In addition, such drugs can cause allergic reactions in a woman and significantly worsen her well-being.

In rare cases, general anesthesia is needed. This method is acceptable if the woman's life is in danger, and it is impossible to perform the operation using other anesthesia. For example, a pregnant woman developed peritonitis as a result of purulent appendicitis, and epidural anesthesia is contraindicated due to some kind of disease.

When using such anesthesia, especially in early pregnancy, many side effects can occur. If intravenous administration of drugs is used, they penetrate the fetus and disrupt the functioning of its nervous and cardiovascular systems. The prognosis depends on the duration of the operation and the drug used.

In the case of inhalation anesthesia (through a mask), there is no way to control breathing with artificial lung ventilation. Therefore, the risk of vomiting during sleep, aspiration pneumonia, and hypotension remains. But for the baby, such anesthesia in the first trimester of pregnancy is safer, since harmful substances do not enter him.

Long-term observations show that the use of modern drugs for anesthesia and the necessary equipment to maintain a woman's condition during sleep virtually eliminates harm to the woman and the fetus. Here's what the statistics say:

The mortality rate during anesthesia is independent of pregnancy and corresponds to the same meager rate as in women outside of pregnancy and this is 1:300,000.
The development of congenital malformations in the fetus is not associated with anesthesia: the ratio of fetal anomalies that have arisen in women after anesthesia and those who have not experienced such a procedure is the same.
The probability of spontaneous termination of pregnancy after anesthesia is 11%. True, almost all cases were recorded after anesthesia during the first eight gestational weeks. After the first trimester, the risk of losing a baby is minimal.
The use of anesthesia in the third trimester provokes preterm labor in only 8% of women.

When You May Need Anesthesia During Pregnancy

Obstetricians do their best to prevent the introduction of any drugs to pregnant women, including drugs for all types of anesthesia. But there is always an emergency when it is impossible to do without anesthesia.

In obstetric practice, an indication for anesthesia may be:

appendectomy;
emergency cholecystectomy (removal of the gallbladder with a stone in the duct);
removal of a tumor or cyst;
emergency dental manipulation (pulpitis, acute gingivitis);
gynecological procedure to eliminate isthmic-cervical insufficiency;
urgent caesarean section;
other interventions.

Important! The most dangerous periods for anesthesia are called the period between 2 and 8 weeks, as well as between 14 and 29 weeks.

What kind of anesthesia is possible during pregnancy - approved drugs

A safe and acceptable type of anesthesia during gestation is local. An anesthetic drug is administered by injection, which allows you to completely freeze a specific area of \u200b\u200bthe body. Of course, local anesthesia is not suitable for abdominal operations, but it is possible to suture, remove a tooth or open an abscess without much difficulty.

In the gestational period, Lidocaine is used for injections. It can penetrate to the fetus in microdoses, but it does not have a systemic effect and is quickly excreted. In a small dosage, the introduction of Novocaine is allowed, but it is advisable to use another pain reliever instead.

On a note! The dosage of the painkiller is selected taking into account the weight, duration of the procedure and gestational age. For a woman of average weight, this can be ½ and 1 ampoule. The duration of local anesthesia is 1-2 hours.

Local anesthesia of the teeth during pregnancy is never performed using Primakain or Ultracain. These anesthetics contain adrenaline and quickly penetrate into the bloodstream. This narrows the lumen of the vessels and provokes fetal hypoxia.

During pregnancy, modern drugs for general anesthesia are used. An experienced anesthesiologist selects the appropriate dose and method of anesthesia, which is well tolerated and rarely causes adverse reactions in pregnant women.

Important! If a woman needs to treat her teeth during pregnancy, anesthesia is performed only after agreement with the obstetrician-gynecologist.

Anesthesia in dentistry during pregnancy

The best time to visit a dentist is the second trimester. In this period, there is no increased threat of abortion, and the anesthetics used can no longer disrupt the development of the fetus.

The need for the use of painkillers does not always exist. So, if a woman is to have a tooth removed during pregnancy, anesthesia is necessary, because it is unacceptable to endure pain in this position. And if you need to cure superficial caries, then you can completely do without the use of medicine.

When a pregnant woman may need anesthesia:

extraction of teeth;
cleaning teeth from stones, plaque;
treatment of caries, gingivitis.

On a note! In the gestational period, implantation, teeth whitening, braces, and radiography are not performed.

Dental treatment during pregnancy with anesthesia - contraindications

The use of any type of anesthesia in the gestational period is contraindicated in:

the presence of neurological pathologies;
diseases that lead to abnormal blood clotting;
individual intolerance to the used anesthetics;
in the first trimester of pregnancy.

Important! It is undesirable to carry out any dental procedures at the 9th month of pregnancy. A visit to the dentist at this time can provoke uterine hypertonicity and the onset of labor.

If it is not possible to avoid anesthesia during pregnancy, make sure that you trust your doctor and are confident in his competence. Remember, there are many anesthetics available today, but not all of them are allowed during pregnancy, so if you have a major operation or dental treatment, discuss all the details with your ob/gyn to eliminate all risks.