From the Guidelines
Lidocaine is generally considered safe for trigger point injections during lactation. The medication has minimal systemic absorption when used for local injections, and very little passes into breast milk [ 1 ]. When lidocaine does enter the maternal circulation, it has a short half-life and is rapidly metabolized by the liver, further reducing infant exposure. Most healthcare providers recommend continuing breastfeeding as normal after receiving trigger point injections with lidocaine. No special precautions or waiting periods are typically necessary between the injection and breastfeeding. The safety profile is even better with standard concentrations (0.5-2%) and when using the smallest effective dose.
Key Considerations
- Lidocaine has been used for decades in various procedures for breastfeeding mothers without documented adverse effects in nursing infants [ 1 ].
- The benefits of pain relief from trigger point injections typically outweigh any theoretical minimal risk to the breastfed infant.
- It is essential to follow guidelines and recommendations for the use of lidocaine in breastfeeding women, as outlined in the Association of Anaesthetists guideline [ 1 ].
- Other studies, such as the international consensus statement on the use of intravenous lidocaine for postoperative pain and recovery [ 1 ], provide additional information on the safety and efficacy of lidocaine, but the guideline from the Association of Anaesthetists [ 1 ] is the most relevant and recent evidence for this specific question.
Recommendations for Use
- Use the smallest effective dose of lidocaine for trigger point injections.
- Standard concentrations of 0.5-2% are recommended.
- No special precautions or waiting periods are typically necessary between the injection and breastfeeding.
- Healthcare providers should continue to monitor the breastfeeding infant for any potential adverse effects, although these are rare.
From the Research
Safety of Lidocaine for Trigger Point Injections in Lactation
- There are no direct studies provided that assess the safety of lidocaine for trigger point injections specifically in lactation.
- The provided studies focus on the efficacy and safety of lidocaine for trigger point injections in various pain management scenarios, including myofascial pain syndrome 2, 3, cervical anesthesia 4, and residual chronic pain after degenerative lumbar spinal stenosis decompression surgery 5.
- A study on systemic absorption and side effects of locally injected glucocorticoids mentions potential systemic risks but does not directly address lidocaine or its safety in lactation 6.
- Without specific evidence on lactation, it's challenging to determine the safety of lidocaine for trigger point injections in this context.
- Generally, lidocaine is considered safe when used appropriately for trigger point injections, but its use during lactation would require careful consideration of potential risks to the infant, such as exposure to the drug through breast milk.