Rescuing a Low Spinal

  • Thomas L. Archer


A 33-year-old woman, G2P1 at 39 weeks gestation, is having an elective repeat cesarean delivery. The resident places a single-shot spinal anesthetic at the L4-5 interspace (L-1) and very slowly and carefully (L-2) injects 1.6 mL of heavy 0.75% bupivacaine, combined with 100 mcg of preservative-free morphine and 25 mcg of fentanyl.


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    Reynolds F. Neurologic complications of pregnancy and neuraxial anesthesia, p. 744. In: Chapter 32 of Chestnut’s obstetric anesthesia, principles and practice. 5th ed. Philadelphia: Elsevier Saunders; 2014.Google Scholar
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    Kim JT, Shim JK, Kim SH, Jung CW, Bahk JH. Trendelenburg position with hip flexion as a rescue strategy to increase spinal anaesthetic level after spinal block. Br J Anaesth. 2007;98(3):396–400.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Thomas L. Archer
    • 1
  1. 1.Department of Anesthesiology 2008–2015University of California San Diego School of MedicineSan DiegoUSA

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