Fentanyl‐induced Rigidity and Unconsciousness in Human Volunteers Incidence, Duration, and Plasma Concentrations

  title={Fentanyl‐induced Rigidity and Unconsciousness in Human Volunteers Incidence, Duration, and Plasma Concentrations},
  author={James B. Streisand and Peter Lawrence Bailey and L Lemaire and Michael A. Ashburn and Stephen D. Tarver and John R. Varvel and Theodore H. Stanley},
BackgroundMuscle rigidity frequently accompanies induction of anesthesia with opioids. The authors sought to determine whether unconsciousness and amnesia occur when humans develop rigidity and apnea after intravenous fentanyl (without other concomitant anesthetics). MethodsThe Incidence and duration of rigidity and level of consciousness were evaluated and associated plasma concentrations of fentanyl were measured in 12 healthy adult male volunteers given only intravenous fentanyl. Fentanyl… Expand
Evidence for the emergence of an opioid‐resistant respiratory rhythm following fentanyl overdose
It is concluded that the depressed regular respiratory activity emerging during and following fentanyl overdose is uniquely resistant to fentanyl. Expand
Fentanyl‐induced chest wall rigidity and laryngospasm in preterm and term infants
Even low doses of fentanyl can lead to thoracic rigidity in neonates, as found in 4% of neonates after fentanyl administration found in this patient population. Expand
Effect of fentanyl on awakening concentration of sevoflurane.
Logistic regression analysis showed that increasing plasma concentration of fentanyl and increasing age significantly reduced the MAC-awake of sevoflurane. Expand
Postoperative myoclonus and rigidity after anesthesia with opioids.
A case of severe myoclonus that occurred during emergence from anesthesia with sufentanil is reported and previous case reports of postoperative, opioid-related tonic rigidity are reviewed to suggest possible etiologic mechanisms. Expand
Impossible mask ventilation after an unusually low dose fentanyl-induced muscle rigidity in a patient with essential tremor: a case report and review of the literature.
A 79 year old male patient, scheduled for hernia repair, and with a preoperative physical examination of slight hand tremor, received a bolus of 100 mcg (1.2 mcg/kg) fentanyl as primary agent for induction of anesthesia and stopped responding, lost consciousness and developed neck and masseter muscle spasm with jaw closure and thoracoabdominal rigidity. Expand
Progressive electroencephalogram frequency deceleration despite constant depth of propofol-induced sedation*
Despite constant sedation, a longer period of propofol application induces a time-dependent electroencephalogram frequency deceleration, and the use of electroencephalographic derivatives to monitor depth of sedation in the intensive care unit thus should be regarded cautiously. Expand
Biasing Effect Of The Electromyogram On Bis: A Controlled Study During High-Dose Fentanyl Induction
Fentanylinduced rigidity appears to be a dose-related phenomenon which the EMG variable of BIS 3.4 is able to quantify, which may explain discrepancies in previous studies assessing BIS in the presence of neuromuscular activity. Expand
The Effects of Epidural Fentanyl on Hemodynamic Responses During Emergence from Isoflurane Anesthesia and Tracheal Extubation: A Comparison with Intravenous Fentanyl
It is suggested that the significant reduction in arterial pressures responses to tracheal extubation due to epidural fentanyl infusion may arise from more suppression of cough reflex than IV fentanyl infusion, which could be provided by the spinal action of epiduralentanyl as well as the supraspinal action. Expand
Noradrenergic Mechanisms in Fentanyl-Mediated Rapid Death Explain Failure of Naloxone in the Opioid Crisis
In December 2018, the Centers for Disease Control declared fentanyl the deadliest drug in America. Opioid overdose is the single greatest cause of death in the United States adult population (agesExpand
Severe Hypoxemia Prevents Spontaneous and Naloxone-induced Breathing Recovery after Fentanyl Overdose in Awake and Sedated Rats
Hypoxia-induced ventilatory depression during fentanyl induced apnea opposes the spontaneous emergence of a respiratory rhythm, which would have rescued the animals otherwise, and prevents the effects of high dose naloxone. Expand