Ondansetron-induced extrapyramidal symptoms during cesarean section

Dystonic reaction associated with ondansetron administration in a patient with normal pressure hydrocephalus

“…Because of its lack of direct dopamine antagonism, ondansetron was initially not believed to cause extrapyramidal side effects. However, there is a growing series of case reports that describe dystonic reactions after ondansetron administration [3][4][5][6][7][8][9][10][11]. Reactions described have included violent jerking of the whole body, dystonic posturing, cogwheel rigidity with tremor, and isolated chorea in the upper extremities [9,10,7].…”

Acute Dystonic Reaction to General Anesthesia with Propofol and Ondansetron: A Graded Response

“…However, after the launch of this drug, dystonic reactions began being reported in patients who received large doses (8 to 30 mg) for the prevention of nausea and vomiting during chemotherapy. 5,6 Reactions associated with smaller single doses (4 mg) for the prevention of postoperative nausea and vomiting during general anesthesia 3,4 and obstetric anesthesia 7,8 were also being reported. Affected patients often showed a minimal response to procyclidine 9 or diphenhydramine.…”

Extrapyramidal side effects after metoclopramide administration in a post-anesthesia care unit -A case report-

“…In particular, in view of the time of onset of the side effect, ondansetron should also be considered as a causative factor even though no dystonic reaction was elicited by ondansetron during the second operation. The oculogyric crisis in our patient occurred approximately 10 minutes after using metoclopramide and within 30 minutes after using ondansetron, and the onset of ondansetron-induced extrapyramidal reaction reportedly varies from several minutes to 30 minutes [9,10]. …”