{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:18:22Z","timestamp":1782836302604,"version":"3.54.5"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":137,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Ondansetron is a highly selective 5\u2010hydroxytryptamine receptor antagonist and the most commonly used anti\u2010emetic for the prevention of postoperative nausea and vomiting. Ondansetron has a low affinity for dopamine receptors and so extrapyramidal side effects are rare. Here, we present the case of a 14\u2010year\u2010old girl who developed a severe post\u2010operative acute dystonic reaction which included oculogyric crisis. We believe that ondansetron was the most likely cause, although propofol may have been a synergistic or alternative causative agent. The patient had no significant past medical history and had previously undergone two uneventful general anaesthetics which included both ondansetron and propofol. The prolonged duration and severity of the reaction and failure to fully respond to specific treatments resulted in the need for tracheal intubation and transfer to a paediatric intensive care unit. She subsequently recovered uneventfully with no ongoing neurological sequalae. Ondansetron\u2010induced dystonic reactions are rare and unpredictable and can occur in patients who have previously received the drug without complication. They are thought to be caused by an imbalance between inhibitory and excitatory neurotransmitters in the extrapyramidal system. Specific treatments include anticholinergics, antihistamines and benzodiazepines.<\/jats:p>","DOI":"10.1002\/anr3.12258","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T14:06:21Z","timestamp":1700057181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Severe acute drug\u2010induced dystonia in the post\u2010operative period requiring tracheal re\u2010intubation"],"prefix":"10.1002","volume":"11","author":[{"given":"A. V.","family":"Baigent","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Royal United Hospital  Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. A. J.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia North Bristol Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.21466\/ac.ASPDRTO.2015"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2004.03855.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200205000-00034"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2015.03.037"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000058845.72102.F2"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556131309200121"},{"key":"e_1_2_5_8_1","first-page":"330","article-title":"An unexpected complication: acute dystonic reaction following use of ondansetron","volume":"24","author":"Yilmaz R","year":"2017","journal-title":"Journal of Turgut Ozal Medical Centre"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1527-3458.2001.tb00195.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2999(96)00761-3"},{"issue":"1","key":"e_1_2_5_11_1","first-page":"41","article-title":"Ondansetron in the prophylaxis of acute cisplatin\u2010induced nausea and vomiting","volume":"25","author":"Marty M","year":"1989","journal-title":"European Journal of Cancer and Clinical Oncology"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T11:41:14Z","timestamp":1759923674000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1002\/anr3.12258"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12258","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"value":"2637-3726","type":"print"},{"value":"2637-3726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"2023-10-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12258"}}