Neonatal chest wall rigidity following the use of remifentanil for cesarean delivery in a patient with autoimmune hepatitis and thrombocytopenia.
Remifentanil is a useful adjunct in general anesthesia for high-risk obstetric patients. It provides effective blunting of the rapid hemodynamic changes that may be associated with airway manipulation and surgical stimulation. There have been no previous reports of opioid-related rigidity in the neonate delivered by a parturient receiving intraoperative remifentanil. We present a case of short-lived neonatal rigidity and respiratory depression following remifentanil administration during cesarean section to a parturient with autoimmune hepatitis complicated by cirrhosis, esophageal varices and thrombocytopenia.
Department of Anesthesia, Stanford University School of Medicine, Stanford, California, USA. bcarvalho@stanford.edu
B
B
Carvalho
E J
EJ
Mirikitani
D
D
Lyell
D A
DA
Evans
M
M
Druzin
E T
ET
Riley
D000328:Adult; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D002585:Cesarean Section; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D019693:Hepatitis, Autoimmune / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009127:Muscle Rigidity / Q000139:chemically induced* / Q000628:therapy; D010880:Piperidines / Q000009:adverse effects*; D011247:Pregnancy; D000077208:Remifentanil; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000628:therapy; D035441:Thoracic Wall; D013921:Thrombocytopenia / Q000150:complications*
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil