How does fentanyl cause muscle rigidity?

Some studies, including in the review, have indicated that fentanyl and FA-induced respiratory muscle rigidity may occur through enhanced noradrenergic release via activation of α1-adrenergic receptors subsequent to activation of μ-opioid receptors in the locus coeruleus.

Does fentanyl cause skeletal muscle rigidity?

In addition, a study by Henthorn et al posits that an active transporter may contribute to increased fentanyl levels within the CNS. These findings may suggest why skeletal chest wall rigidity is observed more so with fentanyl as compared with equivalent doses of other commonly used opioids.

How is chest wall rigidity treated?

Although this complication is better described in pediatric patients and with anesthetic doses, chest wall rigidity can occur with analgesic doses of fentanyl and related compounds. Management includes ventilatory support and reversal with either naloxone or a short-acting neuromuscular blocking agent.

How is fentanyl administered to the body?

Fentanyl, by the intravenous route, can be administered to both adults and children. The dose of fentanyl should be individualised according to age, body weight, physical status, underlying pathological condition, use of other drugs and type of surgery and anaesthesia.

Can fentanyl be injected into a muscle?

Fentanyl Injection is given by your doctor as an injection into a muscle or a vein. The usual dose of Fentanyl Injection ranges from 25 micrograms to 100 micrograms depending on what it is being used for. Repeat doses may be given in some cases.

How long does wooden chest last?

This phenomenon of fentanyl-induced respiratory muscle rigidity (FIRMR) and laryngospasm is clinically known as wooden chest syndrome (WCS), which occurs within 1 to 2 minutes after injection and lasts ∼8–15 minutes (Grell et al., 1970; Scamman, 1983; Streisand et al., 1993).

Can fentanyl cause chest rigidity?

Chest wall rigidity is a rare side-effect of fentanyl and other opioids that can make ventilation inefficient and a high index of suspicion is needed for diagnosis.

Does remifentanil cause chest wall rigidity?

But in a previous surgery, remifentanil continuous infusion was used and the bolus dose of fentanyl was not used. Thus, we suspect that rapid injection of small bolus dose of fentanyl could be a cause of chest wall rigidity. And the recurrent episodes of desaturation lasted to three hours after surgery.

What does rigidity mean in medical terms?

Definition. Rigidity is a hypertonic state characterized by constant resistance throughout range of motion that is independent of the velocity of movement. It is the result of excessive supraspinal drive (upper motor neuron facilitation) acting on alpha motor neurons; spinal reflex mechanisms are typically normal.

What is rigid muscle?

Rigidity – meaning stiff or inflexible muscles – is one of the main motor symptoms of Parkinson’s, along with tremor and slowness of movement (bradykinesia). Muscles become rigid because of their inability to relax.

How do you administer fentanyl IV?

In ventilated patients, a loading dose of Fentanyl Injection 50 micrograms/ml may be given as a fast infusion of approximately 1 mcg/kg/min for the first 10 minutes followed by an infusion of approximately 0.1 mcg/kg/min. Alternatively the loading dose of Fentanyl Injection 50 micrograms/ml may be given as a bolus.

How do you treat wooden chest syndrome?

The first option is administration of intravenous naloxone, an opioid antagonist and reversal agent for opioid overdose. This is the most common treatment and can result in rapid reversal of chest wall rigidity.