For combined spinal-epidural (CSE) anaesthesia in a parturient undergoing elective LSCS, which complication is SPECIFICALLY associated with the epidural component compared to a spinal alone?

• A Post-dural puncture headache (PDPH) from the spinal needle
• B High spinal from intrathecal dose of local anaesthetic
• C Hypotension from sympathectomy
• D Epidural catheter migration and unpredictable spread of local anaesthetic when test-dosed ✓

Explanation

The epidural component of CSE adds the ability to extend, deepen, or prolong the block but also introduces specific complications: the epidural catheter may migrate intrathecally or intravascularly; the 'epidural space effect' (increased intrathecal spread due to epidural volume effect when an epidural bolus is given) can cause unexpected high block; and the test dose of the epidural catheter must be performed carefully. PDPH is primarily from the spinal (pencil-point needle) — incidence is 1–2% even with pencil-point needles. Hypotension affects spinal and CSE equally.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.