Labour is an emotional experience and involves both physiological and psychological mechanisms.The pain of labour is severe but despite this its memory diminishes with time.Labour pain has two components: visceral pain which occurs during the early first stage and the second stage of childbirth, and somatic pain which occurs during the late first stage and the second stage.The pain of labour in the first stage is mediated by T10 to L1 spinal segments, whereas that in the second stage is carried by T12 to L1, and S2 to S4 spinal segments.Pain relief in labour is complex and often challenging without regional analgesia.Effective management of labour pain plays a relatively minor role in a woman's satisfaction with childbirth.

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Local anaesthetics are drugs that are used clinically to produce reversible inhibition of excitation and conduction in peripheral nerve fibres and produce loss of sensation in a circumscribed area of the body. Local anaesthetics have a common structure (Figure 1) with a lipophilic (aromatic) group joined to a hydrophilic (amine) group by an intermediate chain. This intermediate chain may be either an amide or ester link, hence the two major groups of local anaesthetics are esters and amides (Figure 2). The linkage is important because of the metabolism of that group which has, in the case of esters, led to adverse reactions and limited their use. Knowledge of the physicochemical prop-Local anaesthesia and its safe use in minor surgery erties of a local anaesthetic is important as they influence the pharmacodynamics of that drug.