Expert: Ronald Levy, M.D. - 7/6/2011

Question
QUESTION: I had a baby a little while ago.  After 6 hours of no pain medication an epidural was administered and failed to provide much relief.  This was topped but again failed to provide relief.  After 22 hours it was decided to give me a C section and as a result of the failed epidurals I was advised to have a spinal block.  Almost immediately I felt like I was struggling to breath and after I attempted to tell the staff this I lost all movement and sensation in my entire body except my eyelids.  For the birth and the next 6 hours I was unable to move or communicate apart from responding to questions by blinking my eyes.  My questions are (a) is this called a high block?, (b) what are the possible causes of this.  Is there any truth to the debate that red headed women respond very differently to anaesthesia.

ANSWER: This sounds like a high spinal but it is also confusing. If you say you could only blink your eyes then you also would not be able to breathe and they would have had to intubate you. The cause is either that they gave you too much anesthetic in the spinal (possibly combined with what was in the epidural), or they had your in head down position allowing the local to travel up your spinal canal and numb higher than expected. As for red heads, it is actually true that they are more difficult to anesthethetize (natural redheads) and this is thought to have a genetic component.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your time, I have been so traumatized by this to the point where I wouldn't get pregnant again because of it.  I was definitely breathing ok according to them but I couldn't feel it so I actually thought I was dying. I could not talk or move my limbs, when they asked me to hold my baby they tried to put my arm around him and it flopped limp. The doctors thought I was unconscious while they were sewing me up but I could hear and recall everything they said (which clearly wasn't intended for me to hear). I was lying flat on an operating table, does this qualify as head down? They had mixed up my medical records at some point during the labour with someone else so could this be enough to cause an overdose (I'm pretty short).

Answer
Dosage it dependent on height so that might be an issue in combination with the epidural, etc. As for the medical record mixup, that is unexcusable and they should always check your nameband against the record before doing anything. Don't be put off by one bad experience, it doesn't mean it will happen again.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston