2-Chloroprocaine vs. Lidocaine in a Patient With Hypermobile Ehlers-Danlos Syndrome and a History of Local Anesthetic Resistance: A Case Report.

Patients with hypermobile Ehlers-Danlos syndrome (hEDS) have a higher reported prevalence of local anesthetic (LA) resistance and obstetric complications than the general population. We describe a 33-year-old G2P0010 ASA III parturient with a history of hEDS and lidocaine resistance who presented for an anesthesia consultation in anticipation of possible neuraxial anesthesia. We surmised that performing a neuraxial procedure would require effective skin infiltration of the patient's lumbar area. A skin infiltration test revealed that 3% 2-chloroprocaine provided a much greater numbing effect than 2% lidocaine. The patient desired an unmedicated birth and ultimately delivered in this fashion. Still, our findings highlight the potential benefit of testing multiple LAs in hEDS patients to guide anesthetic planning.