Faculty Opinions recommendation of Respiratory reflex responses of the larynx differ between sevoflurane and propofol in pediatric patients.

2005 ◽  
Author(s):  
Martin Johr
Keyword(s):  
Pediatric Patients ◽  
Reflex Responses ◽  
Respiratory Reflex

Respiratory Reflex Responses of the Larynx Differ between Sevoflurane and Propofol in Pediatric Patients

2005 ◽  
Vol 103 (6) ◽  
pp. 1142-1148 ◽  
Author(s):  
Christine Oberer ◽  
Britta S. von Ungern-Sternberg ◽  
Franz J. Frei ◽  
Thomas O. Erb
Keyword(s):  
Pediatric Patients ◽  
Reflex Responses ◽  
Respiratory Reflex

Respiratory Reflex Responses of the Larynx Differ between Sevoflurane and Propofol in Pediatric Patients

2005 ◽  
Vol 103 (6) ◽  
pp. 1142-1148 ◽  
Author(s):  
Christine Oberer ◽  
Britta S. von Ungern-Sternberg ◽  
Franz J. Frei ◽  
Thomas O. Erb
Keyword(s):  
Pediatric Patients ◽  
Elective Surgery ◽  
Random Order ◽  
Group Differences ◽  
Distilled Water ◽  
Sevoflurane Anesthesia ◽  
Reflex Responses ◽  
Laryngeal Mucosa ◽  
Respiratory Responses ◽  
Respiratory Reflex

Background The effects of anesthetics on airway protective reflexes have not been extensively characterized in children. The aim of this study was to compare the laryngeal reflex responses in children anesthetized with either sevoflurane or propofol under two levels of hypnosis using the Bispectral Index score (BIS). The authors hypothesized that the incidence of apnea with laryngospasm evoked by laryngeal stimulation would not differ between sevoflurane and propofol when used in equipotent doses and that laryngeal responsiveness would be diminished with increased levels of hypnosis. Methods Seventy children, aged 2-6 yr, scheduled to undergo elective surgery were randomly allocated to undergo propofol or sevoflurane anesthesia while breathing spontaneously through a laryngeal mask airway. Anesthesia was titrated to achieve the assigned level of hypnosis (BIS 40 +/- 5 or BIS 60 +/- 5) in random order. Laryngeal and respiratory responses were elicited by spraying distilled water on the laryngeal mucosa, and a blinded reviewer assessed evoked responses. Results Apnea with laryngospasm occurred more often during anesthesia with sevoflurane compared with propofol independent of the level of hypnosis: episodes lasting longer than 5 s, 34% versus 19% at BIS 40 and 34% versus 16% at BIS 60; episodes lasting longer than 10 s, 26% versus 10% at BIS 40 and 26% versus 6% at BIS 60 (group differences P < 0.04 and P < 0.01, respectively). In contrast, cough and expiration reflex occurred significantly more frequently in children anesthetized with propofol. Conclusion Laryngeal and respiratory reflex responses in children aged 2-6 yr were different between sevoflurane and propofol independent of the levels of hypnosis examined in this study.

scholarly journals Acetaminophen at low doses depletes airway glutathione and alters respiratory reflex responses

2013 ◽  
Vol 27 (S1) ◽  
Author(s):  
Gregory J. Smith ◽  
Joseph A. Cichocki ◽  
Jose E. Manautou ◽  
John B. Morris
Keyword(s):  
Low Doses ◽  
Reflex Responses ◽  
Respiratory Reflex

Differences in Respiratory Reflex Responses from the Larynx, Trachea, and Bronchi in Anesthetized Female Subjects

1996 ◽  
Vol 84 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Takashi Nishino ◽  
Tetsuo Kochi ◽  
Masayuki Ishii
Keyword(s):  
Animal Studies ◽  
Dose Dependence ◽  
Depth Of Anesthesia ◽  
Sevoflurane Anesthesia ◽  
Reflex Responses ◽  
Significant Difference ◽  
Airway Irritation ◽  
Site Of Stimulation ◽  
Respiratory Reflex ◽  
Female Subjects

Background Animal studies show that airway receptors responsible for eliciting respiratory protective reflexes are not uniformly distributed in the airways. Based on this information, it is possible that the protective reflex responses to airway irritation in humans may vary, depending on the site of stimulation. The purpose of this study is to examine whether the protective reflex responses evoked from the larynx are different from those evoked from the lower airways and to see how change in depth of anesthesia modifies the protective reflex responses evoked from individual sites. Methods The airway mucosa of the larynx, tracheal carina, and bronchi were stimulated by injection of distilled water (0.5 ml) at two different depths of sevoflurane anesthesia (1.2 and 1.8 MAC) in 11 female subjects breathing spontaneously through the laryngeal mask airway. The respiratory responses were monitored by measuring ventilatory flow and airway pressure. Results At 1.2 MAC of sevoflurane anesthesia, both laryngeal and tracheal stimulation caused protective responses, such as forceful expiratory efforts, apnea, and spasmodic panting, whereas bronchial stimulation caused little or no such responses. There was no significant difference in the incidence of different types of reflex responses between the larynx and the trachea. At 1.8 MAC of sevoflurane, the nature of the elicited responses was very similar to that observed at 1.2 MAC of sevoflurane, showing little dose-dependence of anesthetic effect. Conclusions The respiratory reflex responses evoked by injection of water vary, depending on the site of stimulation. The incidence of various reflex responses was not affected by the changing depth of anesthesia. The sensitivity to airway irritation seems to be greater at the larynx and trachea than at the more peripheral airways.

The effect of intravenous lidocaine on laryngeal and respiratory reflex responses in anaesthetised children*

Anaesthesia ◽  
2012 ◽  
Vol 68 (1) ◽  
pp. 13-20 ◽  
Author(s):  
T. O. Erb ◽  
B. S. von Ungern-Sternberg ◽  
K. Keller ◽  
F. J. Frei
Keyword(s):  
Intravenous Lidocaine ◽  
Reflex Responses ◽  
Respiratory Reflex
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