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Titolo:
Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants
Autore:
Fahnenstich, H; Steffan, J; Kau, N; Bartmann, P;
Indirizzi:
Univ Childrens Hosp, Dept Neonatol, CH-4005 Basel, Switzerland Univ Childrens Hosp Basel Switzerland CH-4005 CH-4005 Basel, Switzerland Univ Bonn, Dept Neonatol, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 Bonn, Dept Neonatol, D-5300 Bonn, Germany
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 3, volume: 28, anno: 2000,
pagine: 836 - 839
SICI:
0090-3493(200003)28:3<836:FCWRAL>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONTINUOUS-INFUSION; ANESTHESIA;
Keywords:
chest wall rigidity; drugs; fentanyl; laryngospasm; muscle rigidity; naloxone; newborn; preterm infant; respiratory distress;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Fahnenstich, H Univ Childrens Hosp, Dept Neonatol, CH-4005 Basel, Switzerland Univ Childrens Hosp Basel Switzerland CH-4005 Switzerland
Citazione:
H. Fahnenstich et al., "Fentanyl-induced chest wall rigidity and laryngospasm in preterm and term infants", CRIT CARE M, 28(3), 2000, pp. 836-839

Abstract

Objective: To assess the occurrence of muscle rigidity after fentanyl administration in premature and term neonates. Design: Prospective case series, observational study. Setting: A university hospital neonatal intensive care unit. Patients: 8/89 preterm end term infants (25-40 wks gestational age) who received fentanyl for perioperative analgesia and sedation or intensive care procedures. Interventions: Mechanical or bag mask ventilation and antagonization with naloxone. Measurements and Main Results: We observed chest wall rigidity in 8 patients after low dosage of fentanyl (3-5 mu g/kg body weight). All patients presented with respiratory distress, hypercapnia, and hypoxemia leading to bradycardia. In two patients, laryngospasm was noted and associated with muscle rigidity, thus making intubation impossible. Naloxone (20-40 mu g/kg bodyweight) reversed the laryngospasm and muscle rigidity immediately, allowing restitution within 1 min. In our patient population, we found fentanyl-induced chest wall rigidity in 4% of neonates after fentanyl administration. Conclusion: Even low doses of fentanyl can lead to thoracic rigidity in neonates. Additionally, we observed laryngospasm in two patients and speculate that it might be a variant of muscle rigidity.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/01/20 alle ore 12:14:25