Accepted
at 12:49 a.m. Nov, 01, 2023
by
dollajas
Author:
cafelinked
Type of change:
New Tags
Rationale for change
Question stem describing a pt. sudden drop in vitals from baseline soon after administration of epidurals consistent with epidural anesthesia, confirmed by recurrent late deceleration.
Screenshot: https://i.imgur.com/SUHXj5S.png
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Text
What is the underlying pathophysiology of hypotension after administration of epidural anesthesia?
{{c1::Sympathetic blockade}} → {{c1::vasodilation and venous pooling}}
{{c1::Sympathetic blockade}} → {{c1::vasodilation and venous pooling}}
Extra
- Treatment includes maternal repositioning (↑ venous return), IV fluid bolus, and vasopressors (phenylephrine, ephedrine)
- Correlates with late decelerations on FHR tracing
- Epidural analgesia blocks sympathetic nerve fibers responsible for vascular tone in the lower extremities, resulting in vasodilation and venous pooling → ↓ cardiac return
- "Sympathetic blockade" was added as a cloze to further clarify the pathophysiology underlying this mechanism (Dec 2025)
- Correlates with late decelerations on FHR tracing
- Epidural analgesia blocks sympathetic nerve fibers responsible for vascular tone in the lower extremities, resulting in vasodilation and venous pooling → ↓ cardiac return
- "Sympathetic blockade" was added as a cloze to further clarify the pathophysiology underlying this mechanism (Dec 2025)
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