An 18 yrs old woman in the active stage of labour requests an epidural anaesthesia for delivery. Immediately following the epidural injection of 12ml of 2% lidocaine, the pt developes hypotension , bradycardia and respiratory depression.What is presumptive diagnosis.
accidental subarachnoid injection: Spinal anesthesia ascending into the cervical levels causes severe hypotension, bradycardia, and respiratory insufficiency. Unconsciousness, apnea, and hypotension resulting from high levels of spinal anesthesia are referred to as a "high spinal," or when the block extends to cranial nerves, as a "total spinal." These conditions can occur following an attempted Epidural/Caudal anesthesia if there is an accidental intrathecal injection. systemic toxicity early manifestation is mostly neurological. vasovagal shock will be manifested as parasympathetic overdrive during the procedure.
Allergy to drug administered
Systemic toxicity to drug administered
Vasovagal shock
Drug entered SA space
Regional Anesthesia