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- Recurrent Desaturation Events due to Opioid-Induced Chest Wall Rigidity after Low Dose Fentanyl Administration
- Sung Yeon Ham, Bo Ra Lee, Taehoon Ha, Jeongmin Kim, Sungwon Na
- Korean J Crit Care Med. 2016;31(2):118-122. Published online May 31, 2016
- DOI: https://doi.org/10.4266/kjccm.2016.31.2.118
- 23,507 View
- 402 Download
- 5 Crossref
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Abstract
PDF - Opioid-induced chest wall rigidity is an uncommon complication of opioids. Because of this, it is often difficult to make a differential diagnosis in a mechanically ventilated patient who experiences increased airway pressure and difficulty with ventilation. A 76-year-old female patient was admitted to the intensive care unit (ICU) after surgery for periprosthetic fracture of the femur neck. On completion of the surgery, airway pressure was increased, and oxygen saturation fell below 95% after a bolus dose of fentanyl. After ICU admission, the same event recurred. Manual ventilation was immediately started, and a muscle relaxant relieved the symptoms. There was no sign or symptom suggesting airway obstruction or asthma on physical examination. Early recognition and treatment should be made in a mechanically ventilated patient experiencing increased airway pressure in order to prevent further deterioration.
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Citations
Citations to this article as recorded by
- Fentanyl-Induced Rigid Chest Syndrome in Critically Ill Patients
Alison J. Tammen, Donald Brescia, Dan Jonas, Jeremy L. Hodges, Philip Keith
Journal of Intensive Care Medicine.2023; 38(2): 196. CrossRef - Effects of fentanyl overdose-induced muscle rigidity and dexmedetomidine on respiratory mechanics and pulmonary gas exchange in sedated rats
Philippe Haouzi, Nicole Tubbs
Journal of Applied Physiology.2022; 132(6): 1407. CrossRef - Challenges in Sedation Management in Critically Ill Patients with COVID-19: a Brief Review
Kunal Karamchandani, Rajeev Dalal, Jina Patel, Puneet Modgil, Ashley Quintili
Current Anesthesiology Reports.2021; 11(2): 107. CrossRef - A Case of Masseter Muscle Rigidity during Awake Intubation under Remifentanil Infusion
Tomoki YAMAGA, Takeshi NEGITA, Masayo SUGIURA, Nobuyuki KIMURA
THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA.2019; 39(3): 274. CrossRef - Opioids and Chest Wall Rigidity During Mechanical Ventilation
Jeffrey P. Roan, Navin Bajaj, Field A. Davis, Natalie Kandinata
Annals of Internal Medicine.2018; 168(9): 678. CrossRef
- Fentanyl-Induced Rigid Chest Syndrome in Critically Ill Patients
- Muscular Rigidity and Pulmonary Edema Following Administration of Low Dose Fentanyl: A Case Report
- Sung Kyu Rim, Jong Il Kim, Yu Bin Son, Ji Heui Lee
- Korean J Crit Care Med. 2012;27(3):197-201.
- DOI: https://doi.org/10.4266/kjccm.2012.27.3.197
- 3,597 View
- 39 Download
- 1 Crossref
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Abstract
PDF
- Fentanyl-induced muscular rigidity has been reported exclusively in patients when large fentanyl dosages were employed in the operating room or in the pediatric intensive care unit. Rigidity and pulmonary edema after analgesic doses of fentanyl had not been reported previously. A 25-year-old man underwent removal of a foreign body and application of an Ilizarov frame of tibia under general anesthesia. The patient received 100 microg of fentanyl during emergence of anesthesia and the procedure of dressing. On arrival to the anesthetic recovery room, the patient presented with muscular rigidity and about 1 hour later, developed pulmonary edema. The notable predisposing factors were rapid injection of fentanyl and history of treatment with antidepressants and haloperidol, modifiers of serotonin and dopamine levels. From this case, we suggest the need for careful observation for the development of muscle rigidity complicating airway management in patients taking antidepressants and antipsychotics, especially after administration of an analgesic dose of fentanyl.
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Citations
Citations to this article as recorded by- Recurrent Desaturation Events due to Opioid-Induced Chest Wall Rigidity after Low Dose Fentanyl Administration
Sung Yeon Ham, Bo Ra Lee, Taehoon Ha, Jeongmin Kim, Sungwon Na
Korean Journal of Critical Care Medicine.2016; 31(2): 118. CrossRef
- Recurrent Desaturation Events due to Opioid-Induced Chest Wall Rigidity after Low Dose Fentanyl Administration
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