Local & Regional Anaesthesia · NEET PG Preparation Anaesthesia
A 28-year-old parturient in active labour requests an epidural analgesia. Following placement of the epidural catheter and a test dose of 3 mL of 1.5…
Practice question from Local & Regional Anaesthesia (NEET PG Preparation Anaesthesia), with the correct answer and a step-by-step solution.
medium · MCQ · Q-EE8ADC
A 28-year-old parturient in active labour requests an epidural analgesia. Following placement of the epidural catheter and a test dose of 3 mL of 1.5% lidocaine with 1:200,000 epinephrine, the patient complains of sudden tinnitus, metallic taste, and circumoral numbness within 45 seconds. What is the most likely cause?
- A.Subarachnoid (spinal) injection
- B.Intravascular injection of the local anaestheticCorrect answer
- C.Normal systemic absorption of epidural dose
- D.Allergic reaction to the preservative
Solution
Immediate neurological symptoms such as tinnitus, metallic taste, and circumoral numbness following a test dose strongly indicate inadvertent intravascular (vein) cannulation, leading to rapid systemic local anaesthetic toxicity. (Note: If epinephrine was included, a sudden heart rate increase of >20 bpm is also a classic sign of intravascular injection).
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