You have given spinal anaesthesia for a caesarean section to an otherwise fit lady. After spinal you made her lie supine and kept a wedge under her right hip to prevent pressure on her inferior vena cava. But, you find her blood pressure falling to 70/48 and pulse to 40 . She starts complaining of numbness of her arms and difficulty in breathing . Soon, she becomes unconscious with pupillary dilatation and cessation of breathing.
What could be the diagnosis? Hypoglycemia High spinal Pressure on aorta and inferior vena cava Total spinal Answer: Yes it's total spinal...no doubt! There's inhibition of cardio-accelerator fibers initially followed by ascending block. Total spinal causes involvement of brain stem and cranial nerves causing apnea and pupillary dilatation .
