The purpose of this study is to determine weather using warmed (body temperature) 0.75% Ropivicaine to convert labour epidural analgesia to surgical anaesthesia, reduces the onset time of surgical block, compared to standard room temperature

In this prospective, randomised, controlled, double-blind study; parturients with functioning labour epidural analgesia requiring conversion to anaesthesia for surgical delivery (SD) - will be randomised into control and intervention groups: room temperature (RT) and body temperature (BT). The control group (RT) will receive room temperature Ropivacaine 0.75%, as is the standard practice. The treatment group (BT) will receive 0.75% Ropivicaine warmed up to 37°C temperature. Block height will be assessed every 2 minutes by a blinded investigator until the loss of sensation to cold at the level of T4, sensation to touch will be used as second modality.

Primary outcome is the time to loss of sensation to cold at T4 bilaterally as assessed with ethyl-chloride spray. Secondary outcomes will include motor block, haemodynamic stability, and use of vasopressors, shivering, sweating, nausea, pruritus, body temperature, intra-operative supplementation, and Apgar scores.

Inclusion Criteria:

• ASA I-II women with an established labour epidural
• Labour analgesia with standard low-dose mixture PCEA
• Need for surgical delivery

Exclusion Criteria:

• Category 1 (crash) CS
• Spinal blockade, suggesting migration of epidural catheter
• Use of epidural bupivacaine 0.25-0.5% within 1 h
• Pyrexial parturian - ≥38°C temperature before administration of top-up
• Multiply pregnancy
• Eclampsia
• An allergy or idiosyncratic reaction to local anaesthetic
• Patient refusal