Serotonin syndrome following spinal anaesthesia for elective caesarean delivery : a case report
Uthayanan, Leshanth Kannan, Thogulava
Uthayanan, Leshanth
Kannan, Thogulava
Abstract
Serotonin syndrome during the perioperative period is difficult to recognise, and its diagnosis can be challenging due to the variety of clinical features that may mimic more familiar conditions known to anaesthetists. Most cases of serotonin syndrome in the perioperative setting have been reported in the postoperative period, with none occurring during a caesarean delivery. We describe an unusual case of intraoperative serotonin syndrome that developed immediately following spinal anaesthesia in a patient undergoing an elective caesarean delivery. The patient, who was taking sertraline at the time of anaesthesia, developed pyrexia, diaphoresis, spontaneous rigidity, episodes of arrhythmias, became unresponsive and went into peri-arrest. We postulate plausible mechanisms, including the role of opioids, intrathecal bupivacaine, and acute stress that may have contributed to the onset of serotonin syndrome. The case underscores the importance of early identification of serotonin syndrome and its presentation in obstetric patients.
MIDER Authors
Date
2025-08-13
Type
Article
Subject
Anaesthesia, Serotonin syndrome, Caesarean section, Analgesics, opioid
Collections
Citation
Uthayanan L, Kannan T. Serotonin syndrome following spinal anaesthesia for elective caesarean delivery: a case report. Int J Obstet Anesth. 2025 Aug 14;64:104755. doi: 10.1016/j.ijoa.2025.104755. Epub ahead of print.
Journal / Source Title
International Journal of Obstetric Anesthesia
DOI
10.1016/j.ijoa.2025.104755
PMID
40876242
Publisher
Elsevier