Accepted at 12:49 a.m. Nov, 01, 2023 by dollajas
Author: cafelinked
Related Note: 1547916049259 1
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

Text
What is the underlying pathophysiology of hypotension after administration of epidural anesthesia?

{{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

- Sympathetic nerve fibers responsible for vascular tone may be blocked by the anesthesia resulting in vasodilation and venous pooling → ↓ cardiac return
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#AK_Step2_v12::#UWorld::105834
#AK_Step2_v12::#Subjects::Neurology::05_Spinal_Cord::Lumbar_Puncture::Complications !AK_UpdateTags::Step2decks::Cheesy-Dorian-(M3)::OBGYN::4-UWorld #AK_Step2_v12::!Shelf::ObGyn::no_dupes #AK_Step2_v12::#Resources_by_rotation::ObGyn::uw::zanki::pregnancy_childbirth_puerperium #AK_Step2_v12::#UWorld::Step::14555 #AK_Step2_v12::!Shelf::#Cards_AnKing_Did::2obgyn #AK_Original_Decks::Step_2::Cheesy_Dorian_(M3) #AK_Step2_v12::#UWorld::Step::105834 #AK_Step2_v12::#UWorld::Step::4146 #AK_Step2_v12::#Resources_by_rotation::ObGyn::uw::dorian #AK_Step2_v12::!Shelf::ObGyn::no_dupes::only_step2 #AK_Step2_v12::Original_decks::Zanki_Step_2::ObGyn::Pregnancy,_Childbirth_&_Puerperium #AK_Step2_v12::#Subjects::*Pharm_Extra::Neuro/Psych::Anesthestics::Local_Anesthetics::Basics #AK_Step2_v12::#OME::05_Obstetrics_and_Gynecology::02_Obstetrics::04_Labor_and_Delivery::05_Obstetrical_Operations #AK_Step2_v12::#UWorld::COMLEX::100936 #AK_Step2_v12::#UWorld::COMLEX::107397 #AK_Step2_v12::#UWorld::COMLEX::102663 #AK_Step2_v12::#OME::Clinical::05_Obstetrics_and_Gynecology::02_Obstetrics::04_Labor_and_Delivery::05_Obstetrical_Operations #AK_Step2_v12::#Subjects::Obstetrics_&_Gynecology::02_Obstetrics_REDO::02_Delivery::Mother::Delivery_Methods::Epidural_Anesthesia #AK_Step2_v12::Original_decks::Dorian::obgyn::uw