For 5 month pregnant women with lacerated wound over index finger 4 x

For 5 month pregnant women with lacerated wound over index finger 4 x 0.5 x 0. 5 active bleeding can I use plain lignocaine for suturing

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plain lignocaine local anesthesia pregnant patient wound suturing safety epinephrine avoid

Yes — plain (epinephrine-free) lignocaine is the appropriate and preferred choice here, for two independent reasons: the pregnancy and the location (finger).

1. Pregnancy safety

Lignocaine (lidocaine) is FDA Pregnancy Category B — the only local anesthetic in that category along with prilocaine/etidocaine, while most other local anesthetics fall into Category C. Animal studies show no teratogenic effect, and it's the local anesthetic of choice for procedures during pregnancy at any trimester, including the first trimester when organogenesis is occurring - Dermatology, 2-Volume Set, 5th ed.; Fitzpatrick's Dermatology. Creasy & Resnik's Maternal-Fetal Medicine confirms lidocaine is "regarded as safe (FDA pregnancy category B)" for excision/local procedures in pregnant patients.

2. Why "plain" (no epinephrine) matters here, independent of pregnancy

The classic and still widely practiced rule is to avoid epinephrine-containing local anesthetic in end-arterial/poor-collateral areas: digits (fingers/toes), ears, nose tip, and penis. The concern is that vasoconstriction from epinephrine in a region with limited collateral blood supply could cause local tissue ischemia/necrosis. So for an index finger laceration, plain lignocaine is the standard regardless of pregnancy status.

(Note: more recent hand-surgery literature, including wide-awake local anesthesia no tourniquet [WALANT] technique, has challenged this dogma and shown low-dose epinephrine can be used safely in digits with careful technique - PMID 36974291. But plain lignocaine remains the safe, conventional, and guideline-consistent choice, especially when you don't need epinephrine's hemostatic effect and want to minimize any variables in a pregnant patient.)

Practical points for this case

Technique: A digital (ring) block or direct wound infiltration with plain 1-2% lignocaine works well for a small (4 x 0.5 x 0.5 cm) finger laceration.
Dose limit: Max dose of plain lidocaine (without epinephrine) is about 4.5-5 mg/kg body weight - lower than the 7 mg/kg allowed with epinephrine, since there's no vasoconstriction to slow systemic absorption. For a typical adult a few mL of 1-2% solution for a digital block stays well within this limit.
Aspirate before injecting to avoid inadvertent intravascular injection.
Controlling active bleeding without epinephrine: use direct pressure, elevation, and/or a temporary digital tourniquet (e.g., a rolled glove finger or rubber band at the base of the digit, released promptly after hemostasis/suturing) rather than relying on epinephrine.
Ask about any prior lidocaine/amide-anesthetic allergy (true allergy is rare) and confirm no cardiac contraindication, though these aren't specific to pregnancy.

Bottom line: Plain lignocaine is safe in pregnancy (Category B) and is exactly the right choice for a digital laceration since epinephrine should be avoided in fingers anyway. You don't need to choose between "pregnancy-safe" and "finger-safe" options here - plain lignocaine satisfies both.

A quick evidence check found no recent systematic reviews/meta-analyses that contradict this (searches returned dental-anesthesia and amniocentesis-pain reviews, not directly relevant to traumatic wound suturing), so the guidance above reflects standard, current practice.

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