Central Journal of ISA

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Opioid induced muscle rigidity and myoclonus is a frequently described complication which occurs more commonly with large doses and rapid administration of the drugs and is observed at the time of induction. In the post-operative period this complication is reported in patients undergoing cardiac surgery, where large dosages of fentanyl or analogs are employed. Rigidity and myoclonus in the postoperative period with analgesic doses of opioids is extremely rare. We report a case where a life threatening chest wall rigidity and myoclonus occurred in a patient where fentanyl was used as an intraoperative analgesic in a relatively low dose. Though the mechanism of occurrence of this phenomenon remains unclear but the fact that the rigidity was terminated with naloxone confirms that it was fentanyl induced.

Keywords

Chest Wall Rigidity, Fentanyl, Myoclonus, Naloxone, Post-Operative.
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