Bupivacaine During Pregnancy and Breastfeeding

Medications

Obie Editorial Team

Generic Name: Bupivacaine
Indications: Local anesthesia.
FDA Drug Category: C

Summary Recommendations
Bupivacaine is an injected or epidural local anesthetic commonly used during hip surgery or to reduce pain at a surgical site.

Brand names for bupivacaine include Marcaine, Marcaine Spinal, Sensorcaine, Sensorcaine Forte, Sensorcaine-MPF, Sensorcaine-MPF Spinal, Marcain and Marcain Heavy.

General Precautions
Bupivacaine is a general anesthetic commonly used during surgery or after surgical procedures to reduce pain. The pregnancy category C means sufficient human studies have not been performed or no side effects have been reported in human pregnancies. However, there have been negative side effects on the fetus in animal studies. This medication should only be used if there are no other anesthetics available or if the benefits of using bupivacaine outweigh the risks to the fetus. Side effects reported in animal studies include skeletal deformations and increased risk of fetal death.

Effect While Trying to Conceive

The effect of bupivacaine on fertility has been clinically tested. There are no studies proving any negative effect on fertility or conception.

Effects on Pregnancy

Bupivacaine has been used as an obstetrical anesthetic. As such, doctors must watch patient blood pressure and fetal heart rate after use. There are reports of anesthetics prolonging the final stages of labor, but this effect is across the board and not specific to bupivacaine. Infants may experience reduced muscle tone and strength for up to two days after anesthetic use, but again this is not a reaction specific to this drug.

Safe During Breastfeeding

Bupivacaine passes to the infant in breast milk. There have been no negative side effects reported, but information on the drug published by the National Institutes of Health claim potential serious side effects on nursing infants. The nature or details of these side effects are not listed. Side effects of using bupivacaine in children include abnormalities of the cardiovascular system. This could be one of the possible side effects experienced by infants exposed to the anesthetic in breastmilk. Other side effects in children include high levels of bupivacaine in blood and seizures.