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.
Allergy to drug administered
Systemic toxicity to drug administered
Vasovagal shock
Drug entered SA space
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.
Regional Anesthesia