Abstract:
BACKGROUND:Drugs used for sedation in anesthesia and intensive care may cause pharyngeal dysfunction and increased risk for aspiration. In this study, the authors investigate the impact of sedative doses of morphine and midazolam on pharyngeal function during swallowing and coordination of breathing and swallowing. METHODS:Pharyngeal function, coordination of breathing and swallowing, and level of sedation were assessed by manometry, videoradiography, measurements of respiratory airflow, and a visual analog scale in 32 healthy volunteers (age 19 to 35 yr). After baseline recordings, morphine (0.1 mg/kg) or midazolam (0.05 mg/kg) was administered intravenously for 20 min, followed by recordings at 10 and 30 min after the end of infusion. RESULTS:Pharyngeal dysfunction, seen as misdirected or incomplete swallowing or penetration of bolus to the airway, increased after morphine infusion to 42 and 44% of swallows compared with 17% in baseline recordings. Midazolam markedly increased incidence of pharyngeal dysfunction from 16 to 48% and 59%. Morphine prolonged apnea before swallowing, and midazolam increased the number of swallows followed by inspiration. CONCLUSION:Morphine and midazolam in dosages that produce sedation are associated with increased incidence of pharyngeal dysfunction and discoordinated breathing and swallowing, a combination impairing airway protection and potentially increasing the risk for pulmonary aspirations.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Hårdemark Cedborg AI,Sundman E,Bodén K,Hedström HW,Kuylenstierna R,Ekberg O,Eriksson LIdoi
10.1097/ALN.0000000000000657subject
Has Abstractpub_date
2015-06-01 00:00:00pages
1253-67issue
6eissn
0003-3022issn
1528-1175journal_volume
122pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract::Systemic pretreatment with ketanserin, a relatively specific type-2 serotonin receptor antagonist, significantly attenuated the muscle rigidity produced in rats by the potent short-acting opiate agonist alfentanil. Following placement of subcutaneous electrodes in each animal's left gastrocnemius muscle, rigidity was ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198709000-00012
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Isoflurane induces cell death in neurons undergoing synaptogenesis via increased production of pro-brain-derived neurotrophic factor (proBDNF) and activation of postsynaptic p75 neurotrophin receptor (p75). Astrocytes express p75, but their role in neuronal p75-mediated cell death remains unclear. The author...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000824
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The authors investigated the impact of acute normovolemic hemodilution (ANH) on intrarenal oxygenation and its functional short-term consequences in pigs. METHODS:Renal microvascular oxygenation (µPO2) was measured in cortex, outer and inner medulla via three implanted optical fibers by oxygen-dependent que...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31829bd9bc
更新日期:2013-08-01 00:00:00
abstract::There has been a dramatic growth of scholarly articles in medical education in recent years. Evaluating medical education research requires specific orientation to issues related to format and content. Our goal is to review the quantitative aspects of research in medical education so that clinicians may understand the...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ALN.0000000000002727
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Although halothane reduces digitalis toxicity, other anesthetics, notably cyclopropane, increase toxicity. This study determined the effects of isoflurane on digitalis toxicity in isolated cardiac tissue and compared these effects with those of halothane. METHODS:Standard microelectrode techniques were used...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199412000-00026
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Dysrhythmias and death occur in patients with acquired long QT syndrome (LQTS). Little information exists regarding interactions between anesthetics and drugs that prolong ventricular repolarization. Therefore the effects of three commonly used intravenous anesthetics on ventricular repolarization were inves...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199711000-00022
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Lidocaine inhalation attenuates histamine-induced bronchospasm while evoking airway anesthesia. Because this occurs at plasma concentrations much lower than those required for intravenous lidocaine to attenuate bronchial reactivity, this effect is likely related to topical airway anesthesia and presumably in...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200103000-00010
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:The current study used recombinant herpes simplex virus type I to increase expression of µ-opiate receptors and the opioid ligand preproenkephalin in peripheral nerve fibers in a mouse model of neuropathic pain. It was predicted that viral vector delivery of a combination of genes encoding the µ-opioid recep...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002063
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Potentiation by general anesthetics of gamma-aminobutyric acid (GABA)-mediated inhibitory transmission in the central nervous system is attributed to GABA(A) receptor-mediated postsynaptic effects. However, the role of presynaptic mechanisms in general anesthetic action is not well characterized, and evidenc...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199810000-00017
更新日期:1998-10-01 00:00:00
abstract::Because propofol has cerebral effects similar to those observed for barbiturates, we postulated that it too might offer protection against a focal cerebral ischemic insult. Spontaneously hypertensive male rats were anesthetized with halothane (in 50% O2/balance N2), and their tracheas were intubated and their lungs me...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199205000-00020
更新日期:1992-05-01 00:00:00
abstract::Desflurane (formerly I-653) is a new inhalaticnal anesthetic with a promising pharmacokinetic profile that includes low solubility in blood and tissue, including fat. Since its lipid solubility is less than that of other volatile agents, it may have lower potency. Low solubility would be expected to increase the rate ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199103000-00007
更新日期:1991-03-01 00:00:00
abstract::To determine whether anesthesiologists can manually detect significant changes in pulmonary compliance in neonates using an "educated hand," the authors tested whether clinicians could detect clamping of an endotracheal tube connecting a neonatal lung model to one of three anesthesia breathing circuits. The test lungs...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199110000-00022
更新日期:1991-10-01 00:00:00
abstract::I653 is a new volatile anesthetic structurally similar to enflurane and isoflurane. Since enflurane can induce convulsions, whereas isoflurane progressively depresses cortical electrical activity, the authors believed it important to assess the effect of I653 on the EEG (in both the "time" and "frequency" domain). The...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198809000-00002
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:Knowledge of normal front teeth-to-carina distance (FT-C) might prevent accidental bronchial intubation. The aim of the current study was to measure FT-C and to examine whether the Morgan formula for oral intubation depth, i.e., endotracheal tube (ETT) position at front teeth (cm) = 0.10 x height (cm) + 5, g...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181730288
更新日期:2008-06-01 00:00:00
abstract::The role of the renin--angiotensin system in the maintenance of blood pressure during halothane anesthesia and sodium nitroprusside (SNP)-induced hypotension was evaluated. Control rats received halothane anesthesia (1 MAC) for one hour, followed by SNP infusion, 40 microgram/kg/min, for 30 min, followed by a 30-min r...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:Chloroprocaine has been associated with severe back pain after epidural anesthesia. Factors proposed to contribute to this problem are: 1) the preservative disodium ethylenediaminetetraacetic acid (EDTA), 2) large volumes of chloroprocaine, 3) low pH of chloroprocaine, and 4) local infiltration with chloropr...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199303000-00013
更新日期:1993-03-01 00:00:00
abstract::Total lung capacity, vital capacity, residual volume, and functional residual capacity were determined by body plethysmography and the single-breath oxygen (SBO2) test was performed at 0, 5, and 11 cm H20 continuous positive airway pressure in healthy, awake, seated, spontaneously breathing subjects. Mean values for t...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197502000-00005
更新日期:1975-02-01 00:00:00
abstract:BACKGROUND:During deep brain stimulation implant surgery, microelectrode recordings are used to map the location of targeted neurons. The effects produced by propofol or remifentanil on discharge activity of subthalamic neurons were studied intraoperatively to determine whether they alter neuronal activity. METHODS:Mi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182217126
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Ketamine is an anesthetic drug. Subanesthetic doses of ketamine have been shown to reduce interleukin-6 concentrations after surgery and to reduce mortality and the production of tumor necrosis factor alpha and interleukin 6 in septic animals. Similarly, adenosine was shown to reduce tumor necrosis factor al...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200506000-00017
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers improve cognitive function. The authors therefore tested the primary hypothesis that preoperative use of angiotensin inhibitors is associated with less delirium in critical care patients. Post hoc, the association between postoperativ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003329
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The neural mechanisms underlying the modulation of pain perception by hypnosis remain obscure. In this study, we used positron emission tomography in 11 healthy volunteers to identify the brain areas in which hypnosis modulates cerebral responses to a noxious stimulus. METHODS:The protocol used a factorial ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200005000-00013
更新日期:2000-05-01 00:00:00
abstract::To study the cerebral protective effects of hypothermia in arterial hypoxia, anesthetized (70% N2O), mechanically ventilated rats were cooled to a body temperature of 27 C. Hypoxia was induced by decreasing the oxygen content in the inspired gas mixture either to 6-7 per cent or to 2.5-3 per cent. This reduced mean Pa...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197601000-00006
更新日期:1976-01-01 00:00:00
abstract::Medical records of 38 patients undergoing anesthesia and surgery for removal of an insulinoma were reviewed to determine 1) the safety of avoiding intraoperative glucose, 2) the appropriate frequency of plasma glucose analysis, and 3) the accuracy of using rebound hyperglycemia as an indication of tumor removal. Plasm...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198311000-00001
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Although intravenous patient-controlled analgesia opioids and epidural analgesia offer improved analgesia for postoperative patients treated on an acute pain service, these modalities also expose patients to some risk of serious morbidity and even mortality. Root cause analysis, a process for identifying the...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/ALN.0b013e3182a76f59
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The tuberomammillary histaminergic neurons are involved in the sedative component of anesthetic action. The nucleus basalis magnocellularis (NBM) in the basal forebrain receives dense excitatory innervation from the tuberomammillary nucleus and is recognized as an important site of sleep-wake regulation. Thi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181b061a0
更新日期:2009-10-01 00:00:00
abstract::Exposure of resting rat diaphragm for one hour in vitro to halothane (1-1.5, 2-2.5 and 4-4.5 per cent in oxygen) produced significant alterations of intracellular glucose disposition. Glycolysis (as measured by lactate production) increased, while glycogen formation was inhibited in a dose-related fashion. Net glucose...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197705000-00001
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Telephone quitlines that provide counseling support are efficacious in helping cigarette smokers quit and have been widely disseminated; currently, they are underused. Surgery represents a teachable moment for smoking cessation, which can benefit surgical outcomes; however, few surgical patients receive smok...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e31820d868d
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The current study was designed to investigate the influence of pretreatment with the oxygen radical scavengers polyethylene glycol superoxide dismutase and catalase (SODCAT) on altered opioid-induced pial artery dilation after fluid percussion brain injury (FPI) in the newborn pig. It has been observed previ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199603000-00017
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Xenon has been shown to be neuroprotective in several models of in vitro and in vivo neuronal injury. However, its putative neuroprotective properties have not been evaluated in focal cerebral ischemia. The purpose of this study was to determine if xenon offers neuroprotection in a mouse model of middle cere...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200310000-00020
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:We have previously shown that intralipid (lipid emulsion) protects the heart against ischemia/reperfusion injury and bupivacaine-induced cardiotoxicity. However, the precise underlying mechanisms are not fully understood. Here we explored the hypothesis that free fatty acid receptor-1 or G-protein-coupled re...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002195
更新日期:2018-07-01 00:00:00