L-Ascain Use In Pregnancy & Lactation

Pregnancy: Levobupivacaine should only be used during pregnancy if the benefits outweigh the risks.
Labor and Delivery: Local anesthetics, including levobupivacaine, rapidly cross the placenta, and when used for epidural block, can cause varying degrees of maternal, fetal, and neonatal toxicity. The incidence and degree of toxicity depend upon the procedure performed, the type and amount of drug used, and the technique of drug administration. Adverse reactions in the parturient, fetus, and neonate involve alterations of the central nervous system, peripheral vascular tone, and cardiac function. Maternal hypotension, fetal bradycardia, and fetal decelerations have resulted from regional anesthesia with levobupivacaine for obstetrical pain relief. Local anesthetics produce vasodilation by blocking sympathetic nerves. Administration of intravenous fluids, elevation of the patient's legs and left uterine displacement will help prevent decreases in blood pressure. The fetal heart rate should also be monitored continuously and electronic fetal monitoring is highly advisable.
Lactation: Some local anesthetic drugs are excreted in breast milk and caution should be exercised when levobupivacaine is administered to a nursing woman. The excretion of levobupivacaine or its metabolites in human milk has not been studied.