Rigidity and Hypercarbia Associated with High Dose Fentanyl Induction of Anesthesia

Comstock, M. K.; Carter, James G.; Moyers, John R.; Stevens, Wendell C.

doi:10.1213/00000539-198105000-00018

Cited by 78 publications

(44 citation statements)

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“…The dose of fentanyl administered to our patient was 500 µg over three hours (8 µg·kg -1· hr -1 ), a dose significantly lower than doses usually associated with opioid-induced rigidity and failure of ventilation in anesthesia. 1,15 Venlafexine may have potentiated the development of opioid-induced rigidity.…”

Section: Pathophysiology Of Opioid-induced Rigiditymentioning

confidence: 99%

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Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Roy

Fortier

2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To present and discuss a case of opioid-induced rigidity with low-dose fentanyl during recovery from anesthesia.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : A 41-yr-old woman underwent laparotomy for total abdominal hysterectomy and bilateral salpingo-oophorectomy under general anesthesia. She received a total of 500 µg of fentanyl by iv intermittent boluses during the three-hour anesthetic. During emergence from anesthesia, while intubated, the patient presented with rigidity. No changes in ventilatory parameters were measured during the episode. The only notable predisposing factor was treatment with venlafexine, an antidepressant that modifies serotonin and norepinephrine levels. She was successfully treated with iv naloxone 20 µg. The rest of the postoperative period was uneventful.

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Section: Pathophysiology Of Opioid-induced Rigiditymentioning

confidence: 99%

“…Rigidity classically presents with the use of high-dose opioids during induction of anesthesia in the non-paralyzed patient. 1 Rigidity also occurs during emergence from anesthesia. Although opioid-induced rigidity is part of the differential diagnosis of agitation and abnormal motor symptoms during emergence, it is rare, especially with low doses of opioids.…”

mentioning

confidence: 99%

Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Roy

Fortier

2003

Can J Anesth/J Can Anesth

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“…1 Inability to ventilate the patient during conscious sedation after intravenous administration of benzodiazepines and fentanyl has been reported. 2 We describe a case of postpartum tubal ligation who developed apnoea intra operatively under spinal anesthesia following administration of intravenous midazolam and fentanyl and could not be ventilated.…”

Section: Introductionmentioning

confidence: 99%

Upper airway obstruction in a patient following administration of fentanyl

Kiran¹,

Aggarwal²,

Gupta³

2016

Sri Lankan J Anaesthesiol

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Low dose midazolam and fentanyl are commonly used to provide conscious sedation during regional anaesthesia. Inability to ventilate because of chest wall rigidity following administration of high dose fentanyl has been described. We report a case where midazolam and fentanyl were used to provide sedation and supplementary analgesia during spinal anaesthesia. The patient became unresponsive and apnoeic and could not be ventilated. Anaesthetic circuit was applied, airway was maintained using face mask 100% oxygen was commenced, and CPAP was initiated. After few seconds, she could be ventilated and her spontaneous respiratory efforts returned. Glottic closure secondary to fentanyl administration was thought to be a plausible explanation.

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“…A side-eect of fentanyl, an opioid analgesic with a short duration of action, when given in large doses, is muscle rigidity [3,4,9]. The major use of fentanyl is therefore during anaesthesia, in conjunction with muscle relaxants such as pancuronium.…”

Section: Introductionmentioning

confidence: 99%

Respiratory muscle rigidity in a preterm infant after use of fentanyl during Caesarean section

Lindemann¹

1998

Eur J Pediatr

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Rigidity and Hypercarbia Associated with High Dose Fentanyl Induction of Anesthesia

Cited by 78 publications

References 0 publications

Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Upper airway obstruction in a patient following administration of fentanyl

Respiratory muscle rigidity in a preterm infant after use of fentanyl during Caesarean section

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