Wooden chest syndrome

Wooden chest syndrome is a rigidity of the chest following the administration of high doses of opioids during anaesthesia.[1]

Wooden chest syndrome describes marked muscle rigidity — especially involving the thoracic and abdominal muscles — that is an occasional adverse effect associated with the intravenous administration of lipophilic synthetic opioids such as fentanyl. It can make ventilation difficult, and seems to be reversed by naloxone.[2] Hypoxemia, hypertension, pulmonary hypertension, respiratory acidosis and increased intracranial pressure may supervene.[3]

One recent study hypothesized that chest wall rigidity might be at least partially responsible for some deaths related to intravenous injection of fentanyl, which increasingly is appearing in samples of heroin.[2]

References
  1. Chambers, David; Huang, Christopher; Matthews, Gareth (2014). "Anaesthesia and the Lung". Basic Physiology for Anaesthetists (illustrated ed.). Cambridge: Cambridge University Press. p. 107. ISBN 9781107637825. Retrieved 2015-01-31.
  2. Gussow, Leon (March 25, 2016). "Is possible chest wall rigidity after illicit intravenous fentanyl administration clinically significant?". The Poison Review. Retrieved 2018-04-01.
  3. Tanus-Santos, Jose Eduardo (30 November 1998). "Fentanyl is not best anaesthetic induction agent in rapid sequence intubation". The BMJ. Retrieved 2018-04-01.


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