Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration

The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings.