In contrast, the use of levobupivacaine and ropivacaine in small doses for analgesia in labour remains controversial, and bupivacaine remains the intrathecal and extradural local anesthetic of choice in many obstetric units. A change from bupivacaine to one of the newer drugs for analgesia in labour would require evidence documenting a distinct advantage of one the new local anesthetics in providing equivalent pain relief, but with less side effects.