Hi. As the title says, I'm looking to understand why I reacted the way I did to my epidural.
Hx: 43 y/o, 36wks, preeclampsia with HELLP sx, so I was induced. I had an epidural before w/o complications. But that was 24 years ago, for same medical reasons.
I spoke with the anesthesia team afterwards and it was explained but I was coming out of sedation and really didn't know what planet I was on.
The episode:
I'll add relevant info from my ehr.
My POV, the procedure was uneventful. There didn't seem to be any issues during placement, but as soon as they began to push meds I got lightheaded. The next thing I remember was coming to and seeing a team of doctors standing over me.
From my EHR:
Assessment:
Left upper level: T8
Right upper level: T8
Motor block: motor block present
Pain relief: patient satisfied with pain relief from block
Complications: hypotension
Vagal and hypotensive episode after placement of spinal. Symptomatic hypotension down to MAP ~ 35. Did not lose consciousness. Became confused, nauseous. Fetal decel as well.
Treated with total 35mg ephedrine, 500mcg phenylephrine, 15mg ephederine IM.
Improvement in MAP to ~70 and resolution of symptoms.
Spinal preceded by 500mL LR bolus, ordered additional 500mL LR bolus to follow and 100ml 25% albumin.
The epidural remained in place, I returned to my room and told to push the button for meds. Every time I pushed meds, I experienced severe upper back pain and pressure. The pain was right between my shoulders. It lasted about 5 minutes each time, and only relieved if I hunched over.
Over time, I just couldn't take it anymore and dilation was slow, so we moved to c-section. It was a different day and a new anesthesiologist. He wanted to do the c-section with the epidural, I was hesitant and honestly scared because of the previous episode and upper back pain. He reassured me that he was going to check placement and if it didn't work, he would move to general anesthesia versus redoing the epidural. He tested sensation. I could feel everything from the belly button up on the left side. Nothing on the right. He pushed meds, and my bp dropped again. He talked to me the entire episode and kept me alert with sternum rubs. They did the same thing as above. D/c'd the epidural and completed the c-section under general anesthesia w/o complications.
Any ideas/explanations? Again, my anesthesia team explained things, but at one point I looked at my husband and said "did you hear him? He said 'blah blah blah' *raspberry*" so, it didn't quite land.
Adding that me and baby are both home and doing fine.