LAUSR

A 22-year primigravida presented for caesarean section and hip arthrotomy. The preanaesthetic check-up was unremarkable. After preloading with 500 ml of lactated Ringer’s solution, initial epidural catheterisation in sitting position resulted in an unintended dural puncture (UDP). However, epidural catheterisation was successful at L2-L3 interspace in the subsequent attempt. Subarachnoid block (SAB) with 2 ml 0.5% hyperbaric bupivacaine and 10 μg fentanyl was administered at the L4-L5 interspace. The patient was immediately made supine with 15-degree lateral tilt. A few minutes later, a change in the patient’s voice was noticed (low pitch, clear articulation) with a weak cough reflex. The height of sensory block was T1, blood pressure was 108/66 mm Hg, and the heart rate was 78 BPM.