Acute effects of fentanyl on breathing pattern in anaesthetized subjects

Ferguson, Lindsey; Drummond, Gordon B.

doi:10.1093/bja/ael011

Cited by 37 publications

(22 citation statements)

References 25 publications

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“…The timing and magnitude of this rise in PtcCO 2 is compatible with the absorption kinetics of morphine [28, 29]. This rise in CO 2 following morphine administration is not well documented in the published literature in contrast to opioid induced changes in respiratory rate [30]. This again emphasises the value of continuous PtcCO 2 recording vs point values from arterial blood gas sampling or surrogate markers such as respiratory rate.…”

Section: Discussionmentioning

confidence: 88%

The effects of different analgesic regimens on transcutaneous CO₂ after major surgery

et al. 2008

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Summary Ventilatory impairment may be detected by a rise in transcutaneous carbon dioxide levels (PtcCO2). This observational study assessed the clinical utility of PtcCO2 monitoring in the postoperative period, and quantified the effect of different peri‐operative analgesic regimens on postoperative respiratory function. Following pre‐operative baseline PtcCO2 recording, continuous PtcCO2 monitoring was performed in 30 patients after major colorectal surgery for up to 24 h. Mean postoperative values of PtcCO2 were 1.3 kPa (95% CI 1.0–1.5) higher than pre‐operative values (p < 0.001). Patients receiving intravenous opioid patient controlled analgesia had a significantly higher elevation in postoperative PtcCO2 compared to patients receiving epidural infusion analgesia, 1.8 kPa (CI 1.5–2.1) vs 0.7 kPa (CI 0.5–0.9) respectively (p < 0.001). The mean rise in PtcCO2 following a single intravenous bolus of morphine delivered via PCA was 0.05 kPa (SEm 0.01), peaking at 12 min post‐dose. The transcutaneous capnometer successfully recorded data for 98% of the total time it was applied to patients.

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Section: Discussionmentioning

confidence: 88%

The effects of different analgesic regimens on transcutaneous CO₂ after major surgery

et al. 2008

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“…[13][14][15][16] Opioid use is known to affect respiratory timing, and IBI has been recommended as a useful and reproducible measure to characterize the time course of opioid effects on respiration in anesthetized patients. 17,18 IBI variability has also been used to characterize breathing patterns in both infants and adults. [19][20][21] The automated analysis of IBI variability, hence, might provide useful, objective information on the effect of opioid on respiratory rhythms, without need for laborious manual scoring of apnea.…”

Section: Introductionmentioning

confidence: 99%

Respiratory Variability during Sleep in Methadone Maintenance Treatment Patients

Nguyen

Kim

Grunstein

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Methadone maintenance treatment (MMT) patients have a high prevalence of central sleep apnea and ataxic breathing related to damage to central respiratory rhythm control. However, the quantification of sleep apnea indices requires laborious manual scoring, and ataxic breathing pattern is subjectively judged by visual pattern recognition. This study proposes a semi-automated technique to characterize respiratory variability in MMT patients. Methods: Polysomnography, blood, and functional outcomes of sleep questionnaire (FOSQ) from 50 MMT patients and 20 healthy subjects with matched age, sex, and body mass index, were analyzed. Inter-breath intervals (IBI) were extracted from the nasal cannula pressure signal. Variability of IBI over 100 breaths was quantified by standard deviation (SD), coefficient of variation (CV), and scaling exponent (α) from detrended fluctuation analysis. The relationships between these variability measures and blood methadone concentration, central sleep apnea index (CAI), apnea-hypopnea index (AHI), and clinical outcome (FOSQ), were then examined. Results: MMT patients had significantly higher SD and CV during all sleep stages. During NREM sleep, SD and CV were correlated with blood methadone concentration (Spearman R = 0.52 and 0.56, respectively; p < 0.01). SD and CV were also correlated with CAI (R = 0.63 and 0.71, p < 0.001, respectively), and AHI (R = 0.45 and 0.58, p < 0.01, respectively). Only α showed significant correlation with FOSQ (R = −0.33, p < 0.05). Conclusions: MMT patients have a higher respiratory variability during sleep than healthy controls. Semi-automated variability measures are related to apnea indices obtained by manual scoring and may provide a new approach to quantify opioid-related sleep-disordered breathing.

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“…Breathing irregularities are associated with certain environments such as high altitudes, medical conditions, such as heart failure and chronic obstructive pulmonary disease, and the usage of opioids or levodopa 7 8. We excluded one patient who reported breathing problems, including dyspnoea.…”

Section: Methodsmentioning

confidence: 99%

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study

et al. 2013

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ObjectivesDementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease (AD). DLB is characterised by intracytoplasmic inclusions called Lewy bodies that are often seen in the brainstem. Because modulation of the respiratory rhythm is one of the most important functions of the brainstem, patients with DLB may exhibit dysrhythmic breathing. This hypothesis has not yet been systematically studied. Therefore, we evaluated the association between DLB and dysrhythmic breathing.DesignIn this cross-sectional study consecutive inpatients who were admitted for the evaluation of progressive cognitive impairment were enrolled. We assessed breathing irregularity using polysomnographic recordings on bed rest with closed eyes, without reference to the clinical differentiation among DLB, AD and having no dementia.SettingSingle centre in Japan.Participants14 patients with DLB , 21 with AD and 12 without dementia were enrolled in this study.Primary outcome measuresThe coefficient of variation (CV) of the breath-to-breath time was calculated. We also examined the amplitude spectrum A(f) obtained using the fast Fourier transform and Shannon entropy S of A(f) in patients with DLB compared with patients with AD and patients without dementia.ResultsThe values of CV and entropy S were significantly higher in patients with DLB than in patients with AD and patients without dementia. No significant differences were observed between patients with AD and patients without dementia.ConclusionsPatients with DLB exhibit dysrhythmic breathing compared with patients with AD and patients without dementia. Dysrhythmic breathing is a new clinical feature of DLB and the spectral analysis of breathing patterns can be clinically useful for the diagnostic differentiation of DLB from AD.

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Acute effects of fentanyl on breathing pattern in anaesthetized subjects

Abstract: Small doses of opioid given when anaesthesia and carbon dioxide are stable affect respiratory timing predominantly, but in addition changes in the pattern of motor output can be detected.

Cited by 37 publications

References 25 publications

The effects of different analgesic regimens on transcutaneous CO₂ after major surgery

The effects of different analgesic regimens on transcutaneous CO₂ after major surgery

Respiratory Variability during Sleep in Methadone Maintenance Treatment Patients

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study

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Acute effects of fentanyl on breathing pattern in anaesthetized subjects

Abstract: Small doses of opioid given when anaesthesia and carbon dioxide are stable affect respiratory timing predominantly, but in addition changes in the pattern of motor output can be detected.

Cited by 37 publications

References 25 publications

The effects of different analgesic regimens on transcutaneous CO2 after major surgery

The effects of different analgesic regimens on transcutaneous CO2 after major surgery

Respiratory Variability during Sleep in Methadone Maintenance Treatment Patients

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study

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The effects of different analgesic regimens on transcutaneous CO₂ after major surgery

The effects of different analgesic regimens on transcutaneous CO₂ after major surgery