Continuous Epidural Analgesia Using an Ester-Linked Local Anesthetic Agent, 2-Chloroprocaine, During Labor: A Case Report

Anaesthesia for caesarean section in a morbidly obese parturient with history of lignocaine allergy: A case report

Morbidly obese obstetric patients present multiple challenges to the anaesthetist for labour analgesia and anaesthesia for caesarean section. The superiority of regional anaesthesia (RA) using local anaesthetics (LA) to all other techniques in the obese parturient, as well as avoiding complications of general anaesthesia (GA) in a caesarean delivery makes LA allergy in parturients an important issue. We report the first known case of lignocaine allergy in a morbidly obese parturient.

Labor Epidural in a Patient Who is Allergic to Lidocaine: A Case Series

Continuous epidural anesthesia is considered the best modality for pain relief during labor, local anesthetic allergy is an uncommon occurrence but if a patient has an allergy to bupivacaine or lidocaine owing to its cross-reactivity with bupivacaine then it becomes very challenging to manage labor analgesia. A direct challenge test to rule out actual hypersensitivity was not considered a viable option given the risks involved if a severe allergic reaction occurred with the test dose. Using IV opioid-based analgesia has harmful effects for both mother and the baby in addition to decreasing participation of mothers in the birthing process owing to its sedative properties. We report two cases where the mother had a history of lidocaine allergy, so labor analgesia was managed using chloroprocaine patient-controlled epidural analgesia (PCEA).