Which one of the common side effects is seen with fentanyl ?
**Core Concept**
Fentanyl is a potent synthetic opioid analgesic, often used in anesthesia for its rapid onset and short duration of action. Its pharmacological properties and clinical effects are closely related to its action on the opioid receptors in the central nervous system.
**Why the Correct Answer is Right**
Fentanyl, like other opioids, causes significant respiratory depression, which can lead to respiratory failure if not properly managed. However, a more immediate concern is its effect on the respiratory muscles, causing **diaphragmatic rigidity**, which is also known as chest wall rigidity. This condition is characterized by an inability to move the diaphragm and other respiratory muscles, resulting in shallow breathing or apnea. This effect is particularly pronounced when fentanyl is administered rapidly or in high doses. The rigidity is thought to be mediated by the activation of opioid receptors in the brainstem and spinal cord, which inhibit the normal respiratory drive.
**Why Each Wrong Option is Incorrect**
**Option B:** Tachycardia is not a typical side effect of fentanyl. In fact, opioids like fentanyl are more likely to cause **bradycardia**, a decrease in heart rate, due to their central nervous system effects.
**Option C:** Pain in the abdomen is not a common side effect of fentanyl. While opioids can cause constipation, abdominal pain is not typically associated with fentanyl administration.
**Option D:** Hypertension is not a characteristic side effect of fentanyl. In fact, opioids can cause vasodilation and a decrease in blood pressure, particularly in the initial stages of administration.
**Clinical Pearl / High-Yield Fact**
Fentanyl and other opioids can cause a rapid decrease in respiratory function, making it essential to monitor patients closely for signs of respiratory depression, including chest wall rigidity. A simple mnemonic to remember the potential side effects of fentanyl is "RICE": Respiratory depression, Inhibition of gut motility, Chest wall rigidity, and Eye closure (due to miosis).
**✓ Correct Answer: A. Chest wall rigidly**