Dysphagia as a Missing Link Between Post-surgical- and Opioid-Related Pneumonia.

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM
Lung Pub Date : 2024-04-01 Epub Date: 2024-03-27 DOI:10.1007/s00408-024-00672-8
Michael Frazure, Clinton L Greene, Kimberly E Iceman, Dena R Howland, Teresa Pitts
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Abstract

Purpose: Postoperative pneumonia remains a common complication of surgery, despite increased attention. The purpose of our study was to determine the effects of routine surgery and post-surgical opioid administration on airway protection risk.

Methods: Eight healthy adult cats were evaluated to determine changes in airway protection status and for evidence of dysphagia in two experiments. (1) In four female cats, airway protection status was tracked following routine abdominal surgery (spay surgery) plus low-dose opioid administration (buprenorphine 0.015 mg/kg, IM, q8-12 h; n = 5). (2) Using a cross-over design, four naive cats (2 male, 2 female) were treated with moderate-dose (0.02 mg/kg) or high-dose (0.04 mg/kg) buprenorphine (IM, q8-12 h; n = 5).

Results: Airway protection was significantly affected in both experiments, but the most severe deficits occurred post-surgically as 75% of the animals exhibited silent aspiration.

Conclusion: Oropharyngeal swallow is impaired by the partial mu-opioid receptor agonist buprenorphine, most remarkably in the postoperative setting. These findings have implications for the prevention and management of aspiration pneumonia in vulnerable populations.

Abstract Image

吞咽困难是手术后肺炎与阿片类药物相关肺炎之间的缺失环节。
目的:尽管人们越来越重视手术,但术后肺炎仍是手术的常见并发症。我们的研究旨在确定常规手术和手术后阿片类药物对气道保护风险的影响:方法:对 8 只健康成年猫进行了评估,以确定气道保护状态的变化,并在两项实验中发现吞咽困难的证据。(1)对四只雌猫进行常规腹部手术(绝育手术)和低剂量阿片类药物给药(丁丙诺啡 0.015 mg/kg,IM,q8-12 h;n = 5)后的气道保护状态追踪。(2)采用交叉设计,用中等剂量(0.02 毫克/千克)或高剂量(0.04 毫克/千克)丁丙诺啡(IM,q8-12 小时;n = 5)治疗四只天真猫(两公两母):结果:两项实验中,气道保护均受到明显影响,但最严重的缺陷发生在手术后,75%的动物表现出无声吸入:结论:部分μ-阿片受体激动剂丁丙诺啡会损害口咽吞咽功能,尤其是在术后环境中。这些发现对预防和治疗易感人群的吸入性肺炎具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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