Local and regional anaesthesia: chloroprocaine in urgent caesarean: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anaesthesia · Local and regional anaesthesia: chloroprocaine in urgent caesarean

Sample item

An epidural catheter in place for labour must be extended urgently for an emergency caesarean section. Which agent gives the fastest onset and is rapidly hydrolysed in plasma, limiting fetal exposure?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. 2-chloroprocaine

2-chloroprocaine is an ester with a very short plasma half-life, since it is hydrolysed by plasma cholinesterase, and it gives rapid surgical block when used for epidural top-up. Its quick breakdown keeps maternal and fetal blood levels low. The amide agents have slower onset and longer half-lives.

Option by option

  • A. Levobupivacaine 0.125 percent

    Dilute levobupivacaine is a labour concentration and does not give fast surgical block.

  • B. 2-chloroprocaine (correct)

    Correct. A fast-onset ester that plasma cholinesterase destroys within minutes.

  • C. Bupivacaine 0.5 percent

    Bupivacaine is slower in onset and more cardiotoxic after accidental intravenous injection.

  • D. Ropivacaine 0.2 percent

    Dilute ropivacaine is suitable for labour analgesia but is too weak for surgical block.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, 2-chloroprocaine. 2-chloroprocaine is an ester with a very short plasma half-life, since it is hydrolysed by plasma cholinesterase, and it gives rapid surgical block when used for epidural top-up.

Why is "Levobupivacaine 0.125 percent" not the answer?

Dilute levobupivacaine is a labour concentration and does not give fast surgical block.

Why is "Bupivacaine 0.5 percent" not the answer?

Bupivacaine is slower in onset and more cardiotoxic after accidental intravenous injection.

Why is "Ropivacaine 0.2 percent" not the answer?

Dilute ropivacaine is suitable for labour analgesia but is too weak for surgical block.

What concept does this question test?

It tests Local and regional anaesthesia: chloroprocaine in urgent caesarean in Anaesthesia. Its quick breakdown keeps maternal and fetal blood levels low. The amide agents have slower onset and longer half-lives.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local and regional anaesthesia: chloroprocaine in urgent caesarean?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.