Caesarean section under local anaesthesia (CSLA) was performed on a patient with a diagnosis of gravida 2 para 1 living 1, with eight months amenorrhea and uncontrolled, refractory, complicated eclampsia with intrauterine fetal demise and a previous lower segment Caesarean section. As she was at very high risk (ASA Grade III) for main stream anaesthesia, i.e. general/regional, lidocaine (0.5%) was used. CSLA should not be seen as a primitive/retrograde step. Instead, it should be considered to be a life-saving procedure, especially for women in rural India. Anaesthetists are not dispensable but with them on standby one can avoid mainstream anaesthesia complications in high-risk patients.
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