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"Will an epidural make my heart race since I'm sensitive to epi?"

ZocdocAnswersWill an epidural make my heart race since I'm sensitive to epi?


I am 35 weeks pregnant and very sensitive to epinephrine. when i go to the dentist they cannot use it on me because it makes my heart race so they use carbocaine. Will an epidural do the same thing? If so can I get an epidural without epi in it?


Congratulations on the pregnancy. Sorry to hear about the sensitivity to epinephrine, and that you are worried that you may not be able to get an epidural as a result. As you probably already know, epinephrine (or adrenaline) is a neurotransmitter that is made naturally in the human body and is used by the sympathetic nervous system (this is the "fight or flight" system). It has many different functions (more than I will list here), including vasoconstriction, increasing blood pressure, and increasing heart rate. In some people (like yourself) they are very sensitive to its effects and can get adverse effects (like palpitations). Epinephrine is commonly mixed with local anesthetics for a couple of reasons, it causes vasoconstriction locally (so if the area is injected for surgery, it will bleed less), and it prolongs the effects of the anesthetic. In epidural anesthesia a small catheter is placed into the spinal epidural space (just deep to the ligaments between the spine, but superficial to the actual dura). The anesthesia here affects any nerves that come out of the spinal cord and innervate structures in that "region" which is why this is called a "regional anesthetic". The actual anesthetic used should have no epinephrine in it. The only time that epinephrine may be used is during the small shot in the skin of your back to numb it prior to placing the epidural catheter. The anesthesiologist should easily be able to just use a local anesthetic without epi however. I would recommend making an appointment to go over all of this with your anesthesiologist before you get closer to your due date so that there is no confusion later on. I wish you all the best, and congratulations again.

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