Angioedema Following Spinal Anesthesia with Bupivacaine in a Pregnant Woman Undergoing Caesarian: A Case Report and Review of Potential Etiologies

Abstract

Spinal anesthesia with bupivacaine is widely used for cesarean sections but can rarely cause angioedema, a rapid swelling of deep tissues that may lead to airway obstruction. This case report presents the occurrence of angioedema in a pregnant woman with postoperative hyper IgE levels following spinal anesthesia. It highlights the intricate interplay between drug sensitivity, immune dysregulation, and the physiological changes associated with pregnancy. We present a case of a 32-year-old woman with post-operative hyper IgE levels who developed angioedema shortly after getting spinal anesthesia with bupivacaine for a cesarean section. It should be noted that the patient had no prior history of allergic reactions, making the case particularly interesting and challenging. This report's goal is to: 1. Report details of the clinical presentation, management, and outcome of this unusual patient; 2. Investigate the potential etiologies of angioedema, with a focus on the relationship between bupivacaine sensitivity, hyper IgE, and other possible factors; and 3. Highlight the challenges in diagnosis and management when facing angioedema in patients with atypical presentations.