Simons, Jeroen C. P., Pierce, Eric, Diaz-Gil, Daniel ORCID: 0000-0002-4179-5570, Malviya, Sanjana A., Meyer, Matthew J., Timm, Fanny P., Stokholm, Janne B., Rosow, Carl E., Kacmarek, Robert M. and Eikermann, Matthias (2016). Effects of Depth of Propofol and Sevoflurane Anesthesia on Upper Airway Collapsibility, Respiratory Genioglossus Activation, and Breathing in Healthy Volunteers. Anesthesiology, 125 (3). S. 525 - 535. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1528-1175

Full text not available from this repository.

Abstract

Background: Volatile anesthetics and propofol impair upper airway stability and possibly respiratory upper airway dilator muscle activity. The magnitudes of these effects have not been compared at equivalent anesthetic doses. We hypothesized that upper airway closing pressure is less negative and genioglossus activity is lower during deep compared with shallow anesthesia. Methods: In a randomized controlled crossover study of 12 volunteers, anesthesia with propofol or sevoflurane was titrated using a pain stimulus to identify the threshold for suppression of motor response to electrical stimulation. Measurements included bispectral index, genioglossus electromyography, ventilation, hypopharyngeal pressure, upper airway closing pressure, and change in end-expiratory lung volume during mask pressure drops. Results: A total of 393 attempted breaths during occlusion maneuvers were analyzed. Upper airway closing pressure was significantly less negative at deep versus shallow anesthesia (-10.8 +/- 4.5 vs. -11.3 +/- 4.4 cm H2O, respectively [mean +/- SD]) and correlated with the bispectral index (P < 0.001), indicating a more collapsible airway at deep anesthesia. Respiratory genioglossus activity during airway occlusion was significantly lower at deep compared with light anesthesia (26 +/- 21 vs. 35 +/- 24% of maximal genioglossus activation, respectively; P < 0.001) and correlated with bispectral index (P < 0.001). Upper airway closing pressure and genioglossus activity during airway occlusion did not differ between sevoflurane and propofol anesthesia. Conclusions: Propofol and sevoflurane anesthesia increased upper airway collapsibility in a dose-dependent fashion with no difference at equivalent anesthetic concentrations. These effects can in part be explained by a dose-dependent inhibiting effect of anesthetics on respiratory genioglossus activity.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Simons, Jeroen C. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pierce, EricUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diaz-Gil, DanielUNSPECIFIEDorcid.org/0000-0002-4179-5570UNSPECIFIED
Malviya, Sanjana A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, Matthew J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timm, Fanny P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stokholm, Janne B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosow, Carl E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kacmarek, Robert M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eikermann, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-263833
DOI: 10.1097/ALN.0000000000001225
Journal or Publication Title: Anesthesiology
Volume: 125
Number: 3
Page Range: S. 525 - 535
Date: 2016
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1528-1175
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OBSTRUCTIVE SLEEP-APNEA; MUSCLE-ACTIVITY; PREDICT IMMOBILITY; PAINFUL STIMULI; NERVE ACTIVITY; HEART-RATE; F-WAVES; PRESSURE; MIDAZOLAM; SEDATIONMultiple languages
AnesthesiologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/26383

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item