A 25 year old G2P, at 39 weeks gestation is electing to have spinal anaesthesia for a repeat cesarean section. 5 minutes after bupivacaine spinal injection, the patient becomes hypotensive and is complaining of tingling in her fingers with subjective difficulty breathing. Her oxygen saturation remains 100% and blood pressure in 90/60 mmHg The most likely etiology is.
A
Severe patient anxiety
B
Increased peripheral nerve sensitization to local anaesthetics
C
Decrease in volume of CSF in subarachnoid space facilitated higher spread of local anaesthetics
D
Engorgement of epidural veins contributed to inadvertent intravascular injection of local anaesthetic