The effects of pentobarbitone, diazepam and alcohol on oral breathing in neonatal and mature sheep

Wood, G. A.; Harding, Richard

doi:10.1016/0034-5687(89)90089-3

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…This observation has confirmed and extended the findings of previous studies concerning the effects of sedatives, tranquilizers or hypnotics on responses to respiratory stimuli. We have previously shown that the ability of conscious animals to form an effective oral airway and to initiate oral breathing following nasal obstruction was impaired by sedative doses of diazepam and pentobarbitone (Wood & Harding 1989). Our preliminary results in sleeping lambs indicate that prior administration of single doses of diazepam to lambs profoundly impairs their ability to arouse in response to airflow obstruction during subsequent periods of sleep.…”

Section: Effects Of Tranquillisers On Responses To Airway Obstructionmentioning

confidence: 63%

“…We have also initiated studies to determine the effects of administration of commonly used tranquilizers such as benzodiazepines and antihistamines on responses to airway obstruction in sleeping lambs. The latter studies were considered important because previous experiments with non-sleeping lambs showed that pharmacological sedation severely impairs the ability to initiate oral breathing in response to nasal obstruction (Wood & Harding 1989). Furthermore, it is apparent that some SIDS victims may have been treated with tranquilizing drugs prior to death (Kahn & Blum 1982).…”

Section: Responses To Airflow Obstruction In Sleeping Lambsmentioning

confidence: 99%

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Postnatal Development of Responses to Airflow Obstruction

Harding

Jakubowska

McCrabb

1995

Clin Exp Pharma Physio

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1. Obstruction of the upper airway could be an initiating factor in the Sudden Infant Death Syndrome (SIDS). Responses to upper airway obstruction include augmentation of respiratory efforts, active dilation of the upper airway and electrocortical arousal. Vulnerable individuals may fail to mount these responses effectively. 2. Respiratory and arousal responses to obstruction of the upper airway have been investigated in newborn lambs. In conscious lambs, nasal obstruction causes a profound augmentation of inspiratory efforts, mild asphyxiation and eventual formation of an oral airway. The ability to establish an oral airway involves both chemoreception and mechanoreception and improves with age. 3. In sleeping lambs, obstruction of tidal airflow leads to progressive hypoxaemia, augmentation of inspiratory efforts, bradycardia and arousal. Arousal occurs earlier and with less hypoxaemia and bradycardia in non-REM sleep than in REM sleep. Arousal occurs after inspiratory efforts have increased to the same extent during both sleep states, suggesting that mechanoreception, or a sense of inspiratory effort, is important in initiating arousal. 4. Obstruction of nasal tubes tends to cause arousal from sleep earlier, and with less hypoxaemia and less augmentation of inspiratory effort, than when a more compliant face mask is obstructed. This supports the suggestion that mechanoreception, which may be involved in the perception of inspiratory effort, is a determinant of arousal. 5. With increasing postnatal age, lambs become less arousable in response to airflow obstruction when in REM sleep. This suggests that lambs may become progressively more vulnerable to the effects of airway obstruction during the immediate newborn period.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Effects Of Tranquillisers On Responses To Airway Obstructionmentioning

confidence: 63%

Section: Responses To Airflow Obstruction In Sleeping Lambsmentioning

confidence: 99%

Postnatal Development of Responses to Airflow Obstruction

Harding

Jakubowska

McCrabb

1995

Clin Exp Pharma Physio

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“…33 Similar observations have been reported in lambs. 34 Conversely, in rats, other sedatives (including pentobarbital, ketamine, lorazepam, and zolpidem) may actually increase genioglossus muscle activity under certain conditions. [35][36][37] Phasic activity of the sternohyoid muscle during the transition from wakefulness to sleep was not impaired compared to placebo across three doses of trazodone in five English bulldogs.…”

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confidence: 99%

Trazodone Increases the Respiratory Arousal Threshold in Patients with Obstructive Sleep Apnea and a Low Arousal Threshold

Eckert

Malhotra

Wellman

et al. 2014

Sleep

123

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Study Objectives: The effect of common sedatives on upper airway physiology and breathing during sleep in obstructive sleep apnea (OSA) has been minimally studied. Conceptually, certain sedatives may worsen OSA in some patients. However, sleep and breathing could improve with certain sedatives in patients with OSA with a low respiratory arousal threshold. This study aimed to test the hypothesis that trazodone increases the respiratory arousal threshold in patients with OSA and a low arousal threshold. Secondary aims were to examine the effects of trazodone on upper airway dilator muscle activity, upper airway collapsibility, and breathing during sleep. Design: Patients were studied on 4 separate nights according to a within-subjects cross-over design. Setting: Sleep physiology laboratory. Patients: Seven patients with OSA and a low respiratory arousal threshold. Interventions: In-laboratory polysomnograms were obtained at baseline and after 100 mg of trazodone was administered, followed by detailed overnight physiology experiments under the same conditions. During physiology studies, continuous positive airway pressure was transiently lowered to measure arousal threshold (negative epiglottic pressure prior to arousal), dilator muscle activity (genioglossus and tensor palatini), and upper airway collapsibility (Pcrit). Measurements and Results:Trazodone increased the respiratory arousal threshold by 32 ± 6% (-11.5 ± 1.4 versus -15.3 ± 2.2 cmH 2 O, P < 0.01) but did not alter the apnea-hypopnea index (39 ± 12 versus 39 ± 11 events/h sleep, P = 0.94). Dilator muscle activity and Pcrit also did not systematically change with trazodone. Conclusions: Trazodone increases the respiratory arousal threshold in patients with obstructive sleep apnea and a low arousal threshold without major impairment in dilator muscle activity or upper airway collapsibility. However, the magnitude of change in arousal threshold was insufficient to overcome the compromised upper airway anatomy in these patients. Keywords: Arousal, lung, muscles, respiratory physiology, sedative, sleep-disordered breathing, upper airway Citation: Eckert DJ; Malhotra A; Wellman A; White DP. Trazodone increases the respiratory arousal threshold in patients with obstructive sleep apnea and a low arousal threshold. SLEEP 2014;37(4):811-819.

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“…[20–22] During deep anesthesia, increasing doses of pentobarbital have been shown to increase the phasic genioglossus electromyogram, which theoretically increases the size of the airway and decreases collapsibility. [20] Our study did find that apnea with intervention occurred at a lower incidence in the pentobarbital group than in the propofol group.…”

Section: Discussionmentioning

confidence: 99%

Complications of three deep sedation methods for magnetic resonance imaging

Tith

Lalwani

2012

J Anaesthesiol Clin Pharmacol

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Background:Propofol and pentobarbital are commonly used to sedate children undergoing magnetic resonance imaging (MRI).Aim/Objective:To compare the safety of three types of sedation: intravenous propofol (PROP), mixed pentobarbital/propofol (PENT), and mixed pentobarbital group requiring supplemental sedation (PENT SUPP) regimens in pediatric patients following deep sedation (DS) for noncardiac MRI.Materials and Methods:We conducted a case-control study matching 619 cases with complications with 619 controls using data from our institution's sedation database for children deeply sedated for noncardiac MRI. Cases were defined as patients with any complication and we characterized complications from cases, and used a conditional logistic regression model to assess the association between three DS methods and occurrence of complications after adjusting for confounding variables.Results:We found that complications occurred in association with 794 (10.1%) of the 7,839 DSs performed for MRI between 1998 and 2008. Of the 794 cases, 619 cases met inclusion criteria for the study. Among the 619 cases that met inclusion criteria, 24 (0.3% of 7,839 DSs total) were associated with major complications. Type of sedation was significantly associated with the occurrence of complications, and the PENT group was associated with decreased odds of complications when compared to the PROP regimen (OR 0.68; 95% CI 0.46, 0.98; P=0.040) and compared to the PENT SUPP group (OR 0.60; 95% CI 0.31, 0.89; P<0.0001).Conclusions:DS with a pentobarbital technique was associated with decreased odds for complications when compared to a propofol-based technique or a pentobarbital technique requiring supplemental sedation.

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The effects of pentobarbitone, diazepam and alcohol on oral breathing in neonatal and mature sheep

Cited by 9 publications

References 21 publications

Postnatal Development of Responses to Airflow Obstruction

Postnatal Development of Responses to Airflow Obstruction

Trazodone Increases the Respiratory Arousal Threshold in Patients with Obstructive Sleep Apnea and a Low Arousal Threshold

Complications of three deep sedation methods for magnetic resonance imaging

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