Anesthetic Agents During Pregnancy

Although more data are needed, women of reproductive potential working in surgical areas should consider decreasing or eliminating their exposure to anesthetic gases if pregnancy is a possibility. Moreover, postponing elective surgery until after pregnancy or, at least, after the period of organogenesis, also should be considered. Pregnancy tests should be conducted in any woman of reproductive potential before surgery.

Although the data are very limited, small amounts of some local anesthetics such as lidocaine are excreted into breast milk. Because the amounts in the maternal circulation are usually very low, any exposure of a nursing infant probably is clinically insignificant. Mothers exposed to general anesthetics will not be capable of nursing for several hours, thus allowing clearance of the agents from their circulation.

Gerald G. Briggs,  B.PHARM., FCCP, is a pharmacist clinical specialist, Outpatient Clinics, Memorial Care Center for Women at Miller Children’s Hospital in Long Beach, Calif.; a clinical professor of pharmacy at the University of California, San Francisco; and an adjunct professor of pharmacy at the University of Southern California, Los Angeles. He also is a fellow of the American College of Clinical Pharmacy, coauthor of "Drugs in Pregnancy and Lactation," and coeditor of "Diseases, Complications, and Drug Therapy in Obstetrics." He had no disclosures related to the topic of this article.