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Başak Çoruh, MD; Mark R. Tonelli, MD, FCCP; David R. Park, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, University of Washington.

Correspondence to: Başak Çoruh, MD, Pulmonary and Critical Care Medicine, University of Washington, Box 356522, 1959 NE Pacific St, Seattle, WA 98195; e-mail: bcoruh@u.washington.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(3):1083-1084. doi:10.1378/chest.13-1082
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To the Editor:

We thank Dr Medford for his comments on our report describing chest wall rigidity following administration of fentanyl during bronchoscopy.1 At Harborview Medical Center, the large majority of fiber-optic bronchoscopy procedures, including endobronchial ultrasound-guided transbronchial needle aspiration, are performed under moderate sedation. The sedative and analgesic doses used are highly variable, depending on patient age, comorbidities (eg, hepatic, renal, cardiac, or pulmonary disease), and patient tolerance of the procedure. We agree that the dose of fentanyl and the pace of administration contributed to causing this unusual reaction. In addition to minimizing doses of sedatives and analgesics when possible, this case highlights the importance of early identification and treatment of adverse effects.

References

Çoruh B, Tonelli MR, Park DR. Fentanyl-induced chest wall rigidity. Chest. 2013;143(4):1145-1146. [CrossRef] [PubMed]
 

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References

Çoruh B, Tonelli MR, Park DR. Fentanyl-induced chest wall rigidity. Chest. 2013;143(4):1145-1146. [CrossRef] [PubMed]
 
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