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Background and Aims An 18-year-old primigravida lady whose gestational age was 40 weeks presented with pushing- down pain and a gush of liquor of 02 hours duration. She was admitted with 3rd -trimester pregnancy + rupture of membrane+ latent first stage of labor. Later on, cesarean section delivery was decided for failed augmentation. Vital Signs in the operation theatre: BP=130/70, PR=98, RR=22, SPO2 =95% on room air. The airway assessment was reassuring. Aim: Experience Sharing

Methods A Case Report using patient charts, perioperative records and management approaches.

Results Spinal anesthesia was provided under a possible aseptic technique using 2ml of 0.5% isobaric bupivacaine in the sitting position between L3/L4 with a 24 gauge spinal needle. Both the desired sensory & motor blockade was achieved and she was continuously monitored with non-invasive BP, pulse oximetry and ECG. After 20 minutes of spinal anesthesia and delivery of the fetus & placenta, the patient suddenly lost consciousness which was followed by cardiac arrest. Immediately before the loss of consciousness, she was hemodynamically stable. Cardiopulmonary resuscitation was promptly started and 1mg of intravenous adrenaline was given. After 2 minutes, spontaneous circulation was returned. Then she was intubated and transferred to the intensive care unit for post-cardiac arrest care. She was successfully extubated after 10 hours of full recovery and transferred to maternity ward.

Conclusions All anesthesia providers should be aware of the possibility of subdural block during neuraxial anesthesia. Once subdural injection is suspected, it is advisable to start early resuscitation and avoid further hemodynamic and neurologic complications.