Persistent neurologic deficit and adhesive arachnoiditis following intrathecal 2-chloroprocaine injection.

Because of its apparent broad margin of safety 2chloroprocaine has become widely used, especially for epidural analgesia in obstetrics. Other advantages are rapid onset, short duration of action, rapid hydrolysis by plasma cholinesterase in both mother and fetus, and little if any detectable fetal effect. Additionally it is suggested that inadvertent subarachnoid injection of 2-chloroprocaine would produce a blockade of lesser degree and duration than other local anesthetics.’ However, the following case report documents total spinal anesthesia followed by prolonged neurologic impairment after an inadvertent subarachnoid injection of a full epidural dose of 3% 2-chloroprocaine. This patient’s course was further complicated by the development of adhesive arachnoiditis.