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170603 Anaesthesia

A 25 year old G2P, at 39 weeks gestation is electing to have spinal anaesthesia for a repeat cesarean section. 5 minutes after bupivacaine spinal injection, the patient becomes hypotensive and is complaining of tingling in her fingers with subjective difficulty breathing. Her oxygen saturation remains 100% and blood pressure in 90/60 mmHg The most likely etiology is.

ASevere patient anxiety
BIncreased peripheral nerve sensitization to local anaesthetics
CDecrease in volume of CSF in subarachnoid space facilitated higher spread of local anaesthetics
DEngorgement of epidural veins contributed to inadvertent intravascular injection of local anaesthetic
Anaesthesia
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