Chloroprocaine: local anesthetic systemic toxicity in a 9-month infant with paravertebral catheter

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Regional anesthesia use in pediatric patients has a good safety profile. 2-Chloroprocaine is used frequently in infants due to rapid onset, lack of accumulation, and rapid plasma degradation. We present a case of local anesthetic systemic toxicity following the administration of 3% 2-chloroprocaine through a paravertebral catheter in an infant. The episode lasted 40 s followed by complete recovery. The infrequent reporting of local anesthetic systemic toxicity and limited duration of symptoms supports the continued use of 2-chloroprocaine in infants. Volume should be restricted to the smallest amount providing analgesia.

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