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BACKGROUND AND OBJECTIVES: Although 2-chloroprocaine continues to be a useful drug for epidural anesthesia in obstetrics, it has the anomalous action of decreasing the analgesic effectiveness of subsequently administered epidural fentanyl. Some investigators have suggested that 2-chloroprocaine may act at an opioid receptor site to antagonize the effects of fentanyl. The purpose of our studies was to investigate this hypothesis. METHODS: Radioligand binding assays using the mu and kappa opioid receptor-selective radioligands [3H]-DAMGO and [3H]-U69,593, respectively, were performed to determine the potencies of lidocaine, 2-chloroprocaine, and 2-chloroprocaine metabolites at the mu and kappa opioid receptor sites. Electrophysiologic experiments in in vitro hippocampal slice preparations were then used to examine the effects of 2-chloroprocaine at these opioid receptor subtypes. RESULTS: Lidocaine caused a partial reduction of [3H]-DAMGO binding, which was dose-limited owing to the solubility of lidocaine. 2-Chloroprocaine caused complete displacement of [3H]-DAMGO binding, with a median effective concentration of 1.44 +/- 0.36 mM. The EC50 values for [3H]-U69,593 displacement were 177 +/- 47 microM for 2-chloroprocaine and 2.53 +/- 0.48 mM for lidocaine. Assuming a competitive interaction between anesthetic and opioid, the Ki value for 2-chloroprocaine was 435 microM at mu receptors and 49 microM at kappa receptors. In the mu activity bioassay, 2-chloroprocaine reversed the increased neuronal excitability caused by fentanyl, but this effect was further reduced by naloxone. In addition, 2-chloroprocaine did not reverse the after depolarization caused by fentanyl. In the kappa activity bioassay, 2-chloroprocaine produced effects similar to the kappa agonist U69, 593, but these were not antagonized by naloxone. CONCLUSIONS: Although 2-chloroprocaine has binding affinity at mu and kappa opioid receptor sites, it does not appear to act through an opioid receptor to antagonize the physiologic effects of fentanyl.