Asystole during spinal anaesthesia after change from Trendelenburg to horizontal position

We present a case in which progressive bradycardia and sudden cardiac arrest developed in a 26-year-old healthy woman with an ovarian cyst during spinal anaesthesia, immediately after the patient was moved from the 15 degree Trendelenburg to the supine horizontal position. We postulate that a decrease in venous return was the main cause of the cardiac arrest. It should be stressed again that close monitoring during spinal anaesthesia is essential when the patient is subjected to postural changes.