The Diagnosis of Fentanyl-Induced Chest Wall Rigidity: A Case Report

Fentanyl is a widely used opiate drug because of its rapid-acting sedative and analgesic effects. Fentanyl is often used for procedural sedation due to its favorable pharmacokinetics.

We report the case of a woman who developed the uncommon complication of fentanyl-induced chest wall rigidity or wooden chest syndrome following the administration of low-dose fentanyl during an elective pain procedure in the absence of commonly described risk factors. Her clinical presentation included total body muscle rigidity along with difficulty with ventilation. Her condition was ultimately reversed with prompt administration of intravenous naloxone.

Our case reveals that fentanyl-induced chest rigidity is a rare but important adverse event that can potentially occur to any patient. An understanding and awareness of this phenomenon is necessary for all health care providers who may utilize fentanyl for procedural sedation in their practices.