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 complains of lip numbness and becomes apprehensive. What is presumptive diagnosis.
**Core Concept:** Epidural analgesia in labor involves the administration of local anesthetic agents to provide pain relief for the mother without affecting the baby's breathing or heart rate. The most common local anesthetic used is lidocaine, which has a rapid onset and short duration of action.
**Why the Correct Answer is Right:** The correct answer is A (Lidocaine-induced toxicity) because the patient experienced lip numbness and became apprehensive after receiving a 12 ml injection of 2% lidocaine for epidural anesthesia. These symptoms indicate that the lidocaine caused local anesthesia and central nervous system toxicity, respectively.
**Why Each Wrong Option is Incorrect:**
B. "Needle puncture": This option is incorrect because the problem started immediately after the epidural injection, not after a delay due to needle puncture.
C. "Lidocaine concentration": Although the concentration of lidocaine is high (2%), the problem arises from toxicity, not from the concentration itself.
D. "Inadequate technique": This option is incorrect because the problem started immediately after the epidural injection, suggesting toxicity rather than a technical issue with the technique.
**Core Concept (repeated for clarity):** Epidural anesthesia uses local anesthetics, such as lidocaine, to provide pain relief during childbirth without affecting the baby.
**Why the Correct Answer is Right:** Lidocaine-induced toxicity is the correct answer because it results in numbness (lip numbness) and anxiety (apprehensive behavior).
**Why Each Wrong Option is Incorrect:**
B. "Central nervous system toxicity": This option is incorrect because the problem started immediately after the epidural injection, not after a delay due to needle puncture.
C. "Lidocaine concentration": Although the concentration of lidocaine is high (2%), the problem arises from toxicity, not from the concentration itself.
D. "Inadequate technique": This option is incorrect because the problem started immediately after the epidural injection, suggesting toxicity rather than a technical issue with the technique.
**Core Concept (repeated for clarity):** Epidural anesthesia involves the administration of local anesthetics, such as lidocaine, to alleviate pain during childbirth without affecting the fetus.
**Why the Correct Answer is Right:** Lidocaine-induced toxicity is the correct answer because it leads to numbness (lip numbness) and anxiety (apprehensive behavior).
**Why Each Wrong Option is Incorrect:**
B. "Central nervous system toxicity": This option is incorrect because the problem started immediately after the epidural injection, not after a delay due to needle puncture.
C. "Lidocaine concentration": Although the concentration of lidocaine is high (2%), the problem arises from toxicity, not from the concentration itself.
D. "Inadequate technique": This option is incorrect because the problem started immediately after the epidural injection, suggesting toxicity rather than a technical issue with the technique.