The use of bupivacaine [marcaine [R] in obstetric analgesia and in i. v. regional analgesia [Bier’ block] has recently been the subjects of many articles and editorials in medical and lay press. Recommendations on the use bupivacaine have been made by some drug regulatory authorities without significant consultation. Toxic reactions can follow the use of any local anaesthetic and users of any of these drugs must recognize the warning signs of toxicity and be able to resuscitate patients adequately and properly. Bupivacaine is the drug of choice for obstetric epidural analgesia but should not be used in a concentration of greater than 0.5%. It should not be used in Bier’s block