DOI: https://doi.org/10.36347/sjmcr.2026.v14i08.037

Pages: 1913-1915

Carbetocin, a long-acting oxytocin analogue, is widely used to prevent uterine atony. While its safety profile is well-established, its physiological impact can be amplified by a patient’s emotional and metabolic state. We report a case of a 31-year-old parturient undergoing elective cesarean section for twins who experienced a tonic seizure after carbetocin administration. Despite a standard 1-minute intravenous injection, the patient exhibited unresponsive rigidity followed by a seizure. Arterial blood gas analysis (ABGA) revealed acute respiratory acidosis with normal electrolytes. The seizure was attributed to the synergistic effect of carbetocin-induced respiratory depression, spinal anesthesia-related intercostal muscle paralysis, and increased metabolic CO2 production from severe anxiety regarding fetal distress. The patient recovered completely within 5 minutes after low-dose propofol administration and ventilatory support. This case emphasizes the need for vigilant respiratory monitoring following carbetocin administration, especially in anxious parturients.