09/04/2026
Intraperitoneal chloroprocaine 🎬 Four minutes from January 2026 in Grand Cayman — Dr. Dan Katz of Mount Sinai on what to do when the spinal quits mid-cesarean and the baby is already out.
Watch: https://bit.ly/IP-chloroprocaine
The maneuver is an ampule of 3% chloroprocaine in sterile saline irrigation, poured straight into the open belly. Wait one to two minutes — which Katz promised would feel like the longest two minutes of your life — and you buy 20 to 30 minutes of complete abdominal anesthesia.
People have done this for decades, and the safety justification was always chloroprocaine's half-life of 11 to 21 seconds. It's destroyed almost the moment it hits the bloodstream. Turns out nobody had checked whether that held for absorption through the peritoneum.
A team at OHSU measured it. The real in vivo half-life was 5.3 minutes. Not seconds. More than ten times what everyone had assumed. Plasma levels still landed far below toxicity thresholds with no signs of local anesthetic systemic toxicity in any patient — so the technique holds up, just not on the reasoning people had been using.
Katz was equally candid that this was fifteen patients, that efficacy rests on a case series rather than a randomized trial, and that lowering your threshold to convert to general anesthesia isn't a failure.
Faculty who tell you where the evidence actually stops. That's what we're after.
🎬 https://bit.ly/IP-chloroprocaine
Anyone out there using intraperitoneal chloroprocaine on their labor floor — and would your OBs go along with it?
Back January 27–30, 2027 at The Ritz-Carlton, Grand Cayman.
