Introduction Patient resistance to local anesthetics is rarely considered as the cause of regional anesthesia failure.

Case report We report a case of resistance to local anesthetics in a patient with Crohn’s disease who underwent cesarean section under continuous spinal anesthesia.

Discussion Resistance to local anesthetics may be more common than we think, especially among patients with chronic pain. Providers should consider local anesthetic resistance when regional anesthesia is unsuccessful. Further research is needed to determine if skin wheal tests and/or a different local anesthetic could improve results.