What is the most correct statement regarding the use of 3% 2-chloroprocaine?

The statement that the efficacy of epidurally administered opioids may be decreased when using 3% 2-chloroprocaine is the most accurate. This is because 2-chloroprocaine is an ester local anesthetic that can rapidly metabolize, affecting how other medications, such as opioids, interact within the epidural space. If 2-chloroprocaine is present in the epidural space, it may alter the distribution or overall effectiveness of the opioids administered concurrently, potentially reducing their analgesic effects.

In contrast, the other statements have inaccuracies regarding the pharmacological properties of 2-chloroprocaine. While it is indeed rapidly metabolized, the liver is primarily responsible for metabolizing local anesthetics, not the kidneys, making the first statement misleading. As for the third statement, the rapid onset of 2-chloroprocaine is actually due to its low lipid solubility and the ability to quickly diffuse across nerve membranes rather than its high pKa. Lastly, the claim about fetal acidosis leading to high levels in fetal circulation refers more to the properties of other anesthetics rather than specifically highlighting anything characteristic about 2-chloroprocaine. Therefore, the selected choice accurately reflects