Abstract:
PURPOSE:The most important function of the larynx is airway protection which is provided through a polysynaptic reflex closure triggered by the receptors in the glottic and supraglottic mucosa, evoking the reflex contraction of the laryngeal muscles especially by strong adduction of vocal cords. Based on the hypotheses that central facilitation is essential for this bilateral adductor reflex and that its disturbance can result in weakened laryngeal closure, we designed this study to elucidate the effect of central facilitation on this protective reflex. MATERIALS AND METHODS:Seven adult, 20 kg mongrel dogs underwent evoked response laryngeal electromyography under 0.5 to 1.0 MAC (minimum alveolar concentration) isoflurane anesthesia. The internal branch of the superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles. RESULTS:Ipsilateral reflex closure was consistently recorded regardless of anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels were deepened. Additionally, late responses (R2) were detected in one animal at lower level of anesthesia. CONCLUSIONS:Deepened level of anesthesia affects central facilitation and results in the loss of the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may possibly provide a way to prevent aspiration in unconscious patients.
journal_name
Yonsei Med Jjournal_title
Yonsei medical journalauthors
Kim YH,Kang JW,Kim KMdoi
10.3349/ymj.2009.50.3.380subject
Has Abstractpub_date
2009-06-30 00:00:00pages
380-4issue
3eissn
0513-5796issn
1976-2437journal_volume
50pub_type
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journal_title:Yonsei medical journal
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