Spinal anaesthesia using chloroprocaine 1% for caesarean birth

Spinal anaesthesia with hyperbaric bupivacaine is the standard technique for caesarean birth. However, when amide local anaesthetics are contraindicated, alternative strategies are required. We report the management of a patient undergoing emergency caesarean birth for pre-eclampsia in whom a history suggestive of allergy to amide local anaesthetics precluded the use of bupivacaine. A spinal anaesthetic was performed using intrathecal chloroprocaine 1%, an ester local anaesthetic, in combination with diamorphine. An adequate sensory block to the T4 dermatome was achieved promptly. The density and duration of the block were sufficient for surgery, which proceeded uneventfully. Motor and sensory function returned after approximately 70 minutes, and the patient reported a high level of satisfaction with the anaesthetic technique.