[Therapy of postoperative nausea and vomiting in ENT--tardive dyskinesia as an adverse effect of metoclopramid--a case report].

Abstract

BACKGROUND:

Postoperative nausea and vomiting (PONV) are among the most common complications in operative medicine. Especially patients undergoing middle ear surgery or stapedectomy are frequently suffering from PONV. On the other hand vertigo might be a symptom of an operative complication. For symptomatic therapy a various number of different drugs is available.

PATIENT:

We describe the clinical course of a 25-years-old female patient, who presented with massive orofacial tardive dsykinesia after therapy with metoclopramide (MCP). She had stapedectomy in general anaesthesia and suffered from PONV. The dyskinesia was treated successfully with Biperiden 5 mg i. v.

DISCUSSION:

Tardive dyskinesia is a potential and in rare cases irreversible complication of MCP-therapy. The efficiacy of MCP is in controversy. Studies with 5-HT3-antagonists like Ondansetron or neuroleptics like Droperidol show good results in PONV especially after middle ear surgery.

CONCLUSION:

Tardive dyskinesia is a rare but possible drug-related adverse effect of MCP. After review of the literature we can not recommend MCP as an antiemetic drug in PONV.

• Authors: S Tesche, C Henckell, F U Metternich
• Journal: Laryngo- rhino- otologie (Laryngorhinootologie) Vol. 85 Issue 11 Pg. 824-6 (Nov 2006) ISSN: 0935-8943 [Print] Germany
• Vernacular Title: Medikamentöse Therapie bei postoperativer Ubelkeit und Erbrechen in der HNO: Metoclopramid bei umstrittener Wirksamkeit als Auslöser extrapyramidaler Störungen--ein Fallbeispiel.
• PMID: 16586284 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antiemetics
• Muscarinic Antagonists
• Biperiden
• Metoclopramide

Topics

• Adult
• Antiemetics (adverse effects, therapeutic use)
• Biperiden (therapeutic use)
• Dyskinesia, Drug-Induced (diagnosis, drug therapy, etiology)
• Facial Paralysis (chemically induced, diagnosis, drug therapy)
• Female
• Humans
• Metoclopramide (adverse effects, therapeutic use)
• Muscarinic Antagonists (therapeutic use)
• Postoperative Nausea and Vomiting (drug therapy)
• Stapes Surgery