Use of Local Anesthesia for Hand and Upper Extremity Conditions in Pregnancy.

Although many hand and wrist complaints during pregnancy improve with non-operative treatment, these conditions can significantly alter quality of life and may benefit from surgery if unable to be managed conservatively. However, as there is a theoretically higher risk of teratogenic effects in the first trimester, it is recommended that non urgent or elective surgery be delayed until the second trimester. Orthopedic surgeons should be aware of dosages of local anesthetics, especially when combined with vasoconstrictors, such as epinephrine. Patients with pregnancy-related comorbidities may be more prone to experience side effects with these medications at even standard dosages.