Sudden drop in blood pressure during epidural anesthesia surgery

When general spinal anesthesia is used for epidural block, if the puncture needle or epidural catheter is mistakenly entered into the subarachnoid space and cannot be detected in time, the local anesthetic several times more than the amount of spinal anesthesia is injected into the subarachnoid space, which can cause abnormally extensive The block, called general spinal anesthesia, produces an average of 0.24% (0.12% to 0.57%). The main feature of general spinal anesthesia is extensive sensory and motor blockade that develops rapidly after injection. Hypotension is the most common presentation due to sympathetic blockade. If neck 3, neck 4, and neck 5 are involved, paralysis of the diaphragm may occur, and the intercostal muscles are also paralyzed, which may lead to respiratory failure and even respiratory arrest. With hypotension and hypoxia, the patient may quickly become unconscious and unconscious. If the dose is too large, the symptoms are typical and the diagnosis is not difficult, but it must be distinguished from other causes of hypotension and coma. When the dose is low (eg, obstetric analgesia), only abnormally high planes of anesthesia may be present, which is often a sign of inadvertent entry into the subarachnoid space.

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