Profound motor blockade with epidural ropivacaine following spinal bupivacaine

Ropivacaine, a relatively new amide local anaesthetic, reputedly produces l ess motor block than equivalent doses of bupivacaine, potentially combining high-quality analgesia with the ability to ambulate. We report two cases o f prolonged, profound motor block with patient-controlled epidural analgesi a using 0.1% ropivacaine, following spinal bupivacaine for Caesarean sectio n. As there was no evidence of inadvertent intrathecal ropivacaine administ ration or of any neurological injury, we hypothesise that epidural ropivaca ine may interact with intrathecal bupivacaine to prolong its effect.