Rescuing a Low Spinal

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.