Despite 40 years of epidural analgesia, a consensus still does not exist regarding the best local anesthetic or the best technique for the provision of pain relief in early labour. Two new local anesthetics, levobupivacaine and ropivacaine, have recently been introduced into clinical practice because they have shown reductions in cardiovascular and cerebrovascular toxicity in several small animal, large animal and human volunteer studies. Evidence of improved safety from these studies suggest that the new local anesthetics should be used for surgical anesthesia, such as cesarean section, and limb block, where large volume, high concentrations of local anesthetics are required, and the risk of toxicity is high.