Recurrent Desaturation Events due to Opioid-Induced Chest Wall Rigidity after Low Dose Fentanyl Administration
10.4266/kjccm.2016.31.2.118
- Author:
Sung Yeon HAM
1
;
Bo Ra LEE
;
Taehoon HA
;
Jeongmin KIM
;
Sungwon NA
Author Information
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. NSWKSJ@yuhs.ac
- Publication Type:Case Report
- Keywords:
analgesics, opioids;
asthma;
muscle rigidity;
lung diseases, obstructive
- MeSH:
Aged;
Airway Obstruction;
Analgesics, Opioid;
Asthma;
Diagnosis, Differential;
Female;
Femur Neck;
Fentanyl;
Humans;
Intensive Care Units;
Lung Diseases, Obstructive;
Muscle Rigidity;
Oxygen;
Periprosthetic Fractures;
Physical Examination;
Thoracic Wall;
Thorax;
Ventilation
- From:The Korean Journal of Critical Care Medicine
2016;31(2):118-122
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
