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Answer
It is true that the local anesthetics used in epidurals come from the -caine family of
drugs. I think it is definitely a concern that you might have some sort of allergy to
these medications which might prevent their use when it comes time for you to have an
epidural. In addition, I think it is a great idea to talk to your anesthesiologist in
advance to come up with a plan of action.
Having said that, let me tell you that true allergies to this family of drugs is
extremely rare. This is not to say that you do not have an allergy, only that it is
very uncommon. It is much more likely that you have developed an allergy to
something else in the topical solutions - some type of carrier chemical or
something added as a preservative. When used in an epidural, these medications do
not have any additional chemicals or preservatives. The only way to know for sure
would be to get yourself tested for an allergy - and you may need to do this if you
want to be sure you can receive these medications.
If you do indeed have an allergy to these medications, you can discuss your options
with your anesthesiologist. Options include utilizing another form of pain relief
such as intravenous medications, intrathecal narcotics, etc. or trying to use an
epidural while avoiding these medications (using narcotics only or using local
anesthetics of another class). So, these are my recommendations - try to talk to
your anesthesiologist in advance, consider formal testing to find out if you have a
true allergy, consider other options for pain relief if you really do have an
allergy.
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