Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration
- PMID: 20118943
- PMCID: PMC2845513
- DOI: 10.1038/jp.2009.66
Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration
Abstract
The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings.
References
-
- Giroux M, Teixera MG, Dumas JC, Desprats R, Grandjean H, Houin G. Influence of maternal blood flow on the placental transfer of three opioids–fentanyl, alfentanil, sufentanil. Biol Neonate. 1997;72:133–141. - PubMed
-
- Moises EC, de Barros Duarte L, de Carvalho Cavalli R, Lanchote VL, Duarte G, da Cunha SP. Pharmacokinetics and transplacental distribution of fentanyl in epidural anesthesia for normal pregnant women. Eur J Clin Pharmacol. 2005;61:517–522. - PubMed
-
- Nikkola EM, Jahnukainen TJ, Ekblad UU, Kero PO, Salonen MA. Neonatal monitoring after maternal fentanyl analgesia in labor. J Clin Monit Comput. 2000;16:597–608. - PubMed
-
- Fahnenstich H, Steffan J, Kau N, Bartmann P. Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants. Crit Care Med. 2000;28:836–839. - PubMed
-
- Turski L, Havemann U, Schwarz M, Kuschinsky K. Disinhibition of nigral GABA output neurons mediates muscular rigidity elicited by striatal opioid receptor stimulation. Life Sci. 1982;31:2327–2330. - PubMed