A repeat emergency cesarean section was performed on a 32-year-old term-pregnant woman who admitted to abusing both alcohol and cocaine but denied use of cocaine for the past 3 days. Guillain-Barré syndrome had been diagnosed 8 weeks earlier on the basis of leg weakness and inability to walk but had resolved 3 weeks before hospital admission. Physical examination revealed a malnourished appearance with reduced muscle mass in all extremities. No laboratory data were available. General anesthesia was chosen and was induced with thiopental 250 mg followed by succinylcholine 100 mg in rapid sequence. Proper placement of the endotracheal tube was documented by auscultation and capnography. Less than 60 seconds after intubation, the previously normal ECG changed to a slow wide complex trace without p-waves. All anesthetics were discontinued, 100% O2administered and lidocaine 60 mg injected IV. Soon the ECG changed to a coarse trace and no pulse was palpable. CPR was begun. The infant was delivered within 3 min of the start of resuscitation with Apgar scores of 8 and 9 at 1 and 5 min, respectively.