Chest wall rigidity in two infants after low-dose fentanyl administration

Pediatric Emergency Care
Elisabeth DewhirstJoseph D Tobias

Abstract

Since its introduction into clinical practice, it has been known that fentanyl and other synthetic opioids may cause skeletal muscle rigidity. Involvement of the respiratory musculature, laryngeal structures, or the chest wall may impair ventilation, resulting in hypercarbia and hypoxemia. Although most common with the rapid administration of large doses, this rare adverse effect may occur with small doses especially in neonates and infants. We present 2 infants who developed chest wall rigidity, requiring the administration of neuromuscular blocking agents and controlled ventilation after analgesic doses of fentanyl. Previous reports regarding chest wall rigidity after the administration of low-dose fentanyl in infants and children are reviewed, the pathogenesis of the disorder is discussed, and treatment options offered.

References

Mar 1, 1987·Anesthesiology·M Yaster
Oct 1, 1981·Anesthesiology·A B HillR E Bolles
Jun 1, 1981·Acta Anaesthesiologica Scandinavica·J Marty, J M Desmonts
Jul 1, 1993·Critical Care Medicine·J IrazuztaD Wessel
May 1, 1996·Journal of Clinical Anesthesia·D A MacGregor, L A Bauman
Nov 1, 1996·Southern Medical Journal·C GlickB R Parks
Feb 7, 2001·Critical Care Medicine·H FahnenstichP Bartmann
Aug 18, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Chin-Shuang LinMartin S Mok
Feb 27, 2007·Journal of Clinical Anesthesia·Chun-Chang YehChih-Shung Wong
Jun 21, 2007·Acta Anaesthesiologica Scandinavica·H-C HorngC-T Wu
Feb 2, 2010·Journal of Perinatology : Official Journal of the California Perinatal Association·S Eventov-FriedmanE S Shinwell

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Citations

Dec 30, 2014·Saudi Journal of Anaesthesia·Tarun BhallaJoseph D Tobias
Sep 2, 2014·Pediatrics and Neonatology·Gian Maria Pacifici
Apr 3, 2013·Chest·Başak ÇoruhDavid R Park
Jan 14, 2016·Journal of Anesthesia·Mineto Kamata, Joseph D Tobias
Oct 26, 2012·AACN Advanced Critical Care·Peter N JohnsonTracy M Hagemann
Apr 15, 2014·Korean journal of anesthesiology·Ji Yeon Lee, Youn Yi Jo
Apr 9, 2014·Paediatric Anaesthesia·Hua-Cheng LiuQing-Quan Lian
Mar 22, 2016·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Glenn BurnsHenry A Spiller
Oct 25, 2013·Paediatric Anaesthesia·Roland P Neumann, Britta S von Ungern-Sternberg
Mar 10, 2017·Expert Opinion on Drug Safety·Raeford E Brown
Apr 21, 2017·Journal of Intensive Care Medicine·James L HungerfordJoseph D Tobias
Dec 19, 2015·Laboratory Animals·S K RingerJ Y Mauch
Apr 25, 2018·Circulation·Bradley S MarinoUNKNOWN American Heart Association Congenital Cardiac Defects Committee of the Council on Cardiovascular Disease in the Young; Counc
Nov 4, 2015·Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society·Vaidehi AgrawalMohammad Ali Emran
May 25, 2021·British Journal of Pharmacology·Eamonn KellyGraeme Henderson

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