Fentanyl-induced muscle rigidity in a dog during weaning from mechanical ventilation after emergency abdominal surgery: A case report

Vet Med Sci. 2023 Jan;9(1):37-42. doi: 10.1002/vms3.1001. Epub 2022 Nov 21.

Abstract

A 22.5-kg, 8.4-year-old female mixed breed dog was presented for an emergency ovariohysterectomy for pyometra. No neurological abnormalities were observed on preoperative physical examination. Surgery was completed uneventfully under fentanyl- and sevoflurane-based anaesthesia. Cardiorespiratory indices remained stable under mechanical ventilation throughout the procedure. Approximately 23 min after the discontinuation of fentanyl infusion, the investigator noticed jaw closure and stiffness and thoraco-abdominal muscle rigidity. To rule out fentanyl-induced muscle rigidity, naloxone was administered. Following administration of naloxone, there was a return of spontaneous respiratory effort, indicated by capnogram and visible chest wall excursion. Based on the clinical signs and response to naloxone administration, the dog was diagnosed with suspected fentanyl-induced muscle rigidity. Six minutes after the return of spontaneous respiration, the dog was extubated uneventfully without additional naloxone administration. During 4 days of postoperative hospitalization, no recurrent muscle rigidity was observed, and the patient was discharged safely. The total dose of fentanyl administered was 0.61 mg (27 μg kg-1 ).

Keywords: case report; dog; fentanyl; muscle rigidity; opioid; perioperative period.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Muscles
  • Analgesics, Opioid / adverse effects
  • Animals
  • Dog Diseases* / chemically induced
  • Dog Diseases* / surgery
  • Dogs
  • Female
  • Fentanyl* / adverse effects
  • Muscle Rigidity / chemically induced
  • Muscle Rigidity / veterinary
  • Naloxone / therapeutic use
  • Respiration, Artificial / veterinary

Substances

  • Fentanyl
  • Analgesics, Opioid
  • Naloxone