A frail 92-year-old was positioned in lithotomy for a 90-minute rectal procedure under SAB.At the end of the procedure,when the circulating nurse and surgeon gently removed her legs from the position and placed her in a supine position,she experienced a common side effect of spinal anesthesia,____________.
A) numbness of both legs and feet
B) paralysis with bilateral popliteal pain
C) hypotensive episode
D) hypertensive episode

Question

Quizplus · Accepted Answer

Hypotension may occur rapidly after an SAB.It results from vasodilation because the sympathetic nerves that control vasomotor tone are blocked.Peripheral pooling of blood occurs,resulting in reduced venous return to the heart and decreased cardiac output.A hypotensive response usually can be avoided by infusing 750 to 1500 mL of balanced salt solution immediately before the block and placing the patient in a 5-degree head-down position to improve venous return to the heart.A vasopressor,such as ephedrine,also may be appropriate.

A Frail 92-Year-Old Was Positioned in Lithotomy for a 90-Minute