Dewhirst Elisabeth, Naguib Aymen, Tobias Joseph D
Department of Anesthesiology, Nationwide Children's Hospital and the Ohio State University, Columbus, OH 43205, USA.
Pediatr Emerg Care. 2012 May;28(5):465-8. doi: 10.1097/PEC.0b013e3182535a2a.
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.
自芬太尼及其他合成阿片类药物引入临床实践以来，人们就知道它们可能会导致骨骼肌僵硬。呼吸肌、喉部结构或胸壁受累可能会损害通气功能，导致高碳酸血症和低氧血症。虽然这种罕见的不良反应在大剂量快速给药时最为常见，但小剂量给药时也可能发生，尤其是在新生儿和婴儿中。我们报告了2例婴儿，他们在接受镇痛剂量的芬太尼后出现胸壁僵硬，需要使用神经肌肉阻滞剂并进行控制通气。本文回顾了此前关于婴儿和儿童使用低剂量芬太尼后出现胸壁僵硬的报告，讨论了该病症的发病机制，并提供了治疗选择。
