Levobupivacaine and ropivacaine: the new choices for labor analgesia.

For several decades, bupivacaine has enjoyed great clinical popularity as the first choice local anaesthetic for pain control in labour. However, introduction of ropivacaine and most recently levobupivacaine, the two newer and presumably safer (thought to be less cardio- and neurotoxic than bupivacaine) local anaesthetics, has challenged the position of bupivacaine as a gold standard to labour analgesia. Most pregnant patients receive their initial information regarding labour analgesia from primary care providers including family physicians, midwives, and obstetricians. This review article, intended for primary care providers, briefly addresses the current controversies regarding choice of local anaesthetics for pain management in labour.