Hyperventilation-induced unconsciousness during labour

Preoperative anxiety can cause convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery: a case report

Preoperative anxiety in patients under spinal anaesthesia may cause serious complications. We report a case of combined transient convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery in a patient who presented with severe preoperative anxiety. Our patient’s consciousness and blood pressure recovered normally without any sequelae. However, preoperative anxiety can induce such complications, particularly in patients under regional anaesthesia. Therefore, early detection and deliberate management for preoperative anxiety are required for the patient’s safety and satisfaction.

Hyperventilation-induced tetany associated with epidural analgesia for labor

We report a case of painful carpo-pedal spasm associated with the initiation of epidural analgesia for labor. The patient, an otherwise healthy primigravida in early labor at term, was experiencing severe hyperventilation as a result of inappropriate use of the Lamaze breathing technique. Bilateral carpo-pedal spasm occurred, and produced severe pain. Resolution of symptoms coincided with onset of effective epidural labor pain relief. A diagnostic challenge was presented to the anesthesiologist, as the symptoms could have been consistent with subdural block, local anesthetic toxicity, high sensory level of analgesia or eclamptic neuro-excitation activity.

The duff, no duff casualty

A patient who presented with "hyperventilation syndrome" was initially mis-treated as severe crush injury, illustrating the need for thorough assessment of all casualties whilst on exercise prior to arranging casualty treatment and evacuation.