Complications of spinal anaesthesia following extradural block for caesarean section

After extradural blockade failed to extend sufficiently for elective Caesarean section, spinal anaesthesia was performed using 1.6 ml of hyperbaric 0.5% bupivacaine solution in 8% glucose (Marcain Heavy). The patient rapidly developed sensory blockade to the level of T2, and became distressed and dyspnoeic. General anaesthesia was induced. Despite i.v. ephedrine and fluid loading, severe hypotension occurred, which responded subsequently to further doses of ephedrine and infusion of colloid. A healthy infant was delivered by Caesarean section.