Effect of dexmedetomidine sedation on swallowing reflex: A pilot study
Effect of dexmedetomidine sedation on swallowing reflex: A pilot study
复制标题
右美托咪定镇静对吞咽反射的影响：一项初步研究
DOI：
10.1016/j.jds.2019.09.004
复制
发表时间：
2019
影响因子：
3.5
通讯作者：
Takao Ayuse
中科院分区：
文献类型：
--
作者：
Takuro Sanuki;Gaku Mishima;Takao Ayuse
背景/目的在牙科治疗或口腔手术期间吞咽反射抑制可能导致水进入下呼吸道，导致咳嗽，从而阻碍这些程序。基于这一假设，右美托咪定（DEX）镇静可能会抑制吞咽反射，我们的目的是表征其对吞咽反射的影响，并阐明受影响的functions.Materials和MethodsSwallowing反射诱导9名年轻健康男性志愿者使用5毫升蒸馏水推注超过3秒通过聚乙烯导管3次，清醒和DEX镇静下。吞咽肌电爆发持续时间、吞咽前肌电活动值、吞咽肌电爆发峰值、潜伏期时间，结果地塞米松镇静后，肌电爆发持续时间明显延长[（206.9 ± 90.3）%，P <0.01]，与对照组比较，差异有显著性（P <0.05），与对照组比较，差异有显著性（P <0.01）。（1.20 ± 0.98 s）]与清醒状态[100 ± 00%（0.53 ± 0.28 s），P= 0.007]比较。在清醒和DEX镇静之间，吞咽前EMG活动值（P= 0.343）、吞咽EMG爆发峰值（P= 0.218）和潜伏期时间无显著差异（P= 0.793）。吞咽的呼吸周期的时间分布没有显着差异两种条件（P= 0.860）。ConclusionOur数据表明，DEX镇静进行了潜在的风险，由于吞咽反射抑制在提升喉吸气，因此，吸水和唾液应严格执行。然而，颏下肌复合体的外周肌肉收缩、神经组织功能和与呼吸周期相关的吞咽反射的时间不受影响。
Background/purposeSwallowing reflex depression during dental treatment or oral surgery may cause water to enter the lower respiratory tract, leading to coughing, thus hindering these procedures. Based on the hypothesis that dexmedetomidine (DEX) sedation may depress swallowing reflex, we aimed to characterize its effects on swallowing reflex and elucidate the affected functions.Materials and methodsSwallowing reflex was induced in 9 young healthy male volunteers using a 5 mL-distilled water bolus injection over 3 s through a polyethylene catheter 3 times, both under wakefulness and DEX sedation. Swallowing EMG burst duration, pre-swallow EMG activity value, swallowing EMG burst peak value, latency time, and swallowing reflex timing in relation to the respiratory cycle were analyzed.ResultsThe EMG burst duration was significantly prolonged with DEX sedation [206.9 ± 90.3% (1.20 ± 0.98 s)] compared to that with wakefulness [100 ± 00% (0.53 ± 0.28 s),P= 0.007]. No significant differences in the pre-swallow EMG activity value (P= 0.343), swallowing EMG burst peak value (P= 0.218), and latency times were apparent between wakefulness and DEX sedation (P= 0.793). Distributions of timing of the swallows in relation to the respiratory cycle did not significantly differ between the two conditions (P= 0.860).ConclusionOur data demonstrate that DEX sedation carries a potential risk of aspiration due to swallowing reflex depression during elevation of the larynx; therefore, suctioning of water and saliva should be rigorously performed. However, peripheral muscle contraction of the submental muscle complex, neural organization function, and timing of the swallowing reflex in relation to the respiratory cycle are not affected.
登录
查看更多内容
影响因子：
1.2
作者：
Mahajan C;Rath GP;Singh GP;Mishra N;Sokhal S;Bithal PK
通讯作者：
Bithal PK
正常碳酸血症和高碳酸血症期间取消阶段性肺充气对人类吞咽反射的影响
影响因子：
2.8
作者：
T. Sai;S. Isono;T. Nishino
通讯作者：
T. Nishino
影响因子：
2.9
作者：
Ayuse, T;Ayuse, T;Oi, K
通讯作者：
Oi, K
右美托咪定：一种新型镇静镇痛剂
影响因子：
--
作者：
R. Gertler;H. C. Brown;D. H. Mitchell;Erin N. Silvius
通讯作者：
Erin N. Silvius
瑞芬太尼对咽部吞咽的影响：健康志愿者的双盲随机交叉研究
影响因子：
3.6
作者：
J. Savilampi;T. Omari;A. Magnuson;R. Ahlstrand
通讯作者：
R. Ahlstrand