Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 Supp. 2 2024 05 02 641 643 Alireza Babajani Department of Anesthesia, Allied Medical School, Iran University of Medical Sciences, Tehran, Iran. Nafiseh Feizollahzadeh Department of Operating Room, Zahra Mardani Azar Medical Education Center, Tabriz University of Medical Sciences, Iran. Hamed Koohsoltani Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2024 02 04 2024 02 12 A 2-month and 13-day-old boy underwent surgery for a right inguinal hernia. During the procedure, a caudal block was performed using 4 mL of 0.25% bupivacaine injected with an epinephrine-soaked syringe. Before the injection, we confirmed that there was no blood or cerebrospinal fluid present. However, shortly after the injection, the patient experienced respiratory apnea and a slow heart rate. The medical team provided respiratory and cardiac support and closely monitored the patient. After a day and a half, the patient was discharged with no further complications. https://aacc.tums.ac.ir/index.php/aacc/article/view/941