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Laryngorhinootologie 2016; 95(06): 392-398
DOI: 10.1055/s-0041-108262
Originalie
© Georg Thieme Verlag KG Stuttgart · New York

Chemosensorisch evozierte Atemänderungen während zweier Propofol-induzierter Sedierungsstadien

Chemosensory Evoked Changes of Breathing Pattern During Propofol-induced Sedation
H. Gudziol
1   Universitätsklinikum der FSU Jena, Klinik für Hals-, Nasen-, Ohrenheilkunde, Jena
,
R. Gottschall
2   Universitätsklinikum der FSU Jena, Klinik für Anästhesiologie und Intensivtherapie, Jena
,
D. Geil
2   Universitätsklinikum der FSU Jena, Klinik für Anästhesiologie und Intensivtherapie, Jena
,
H. Lehnich
3   Universitätsklinikum der MLU Halle-Wittenberg, Zentrum für Medizinische Grundlagenforschung, Halle
,
T. Bitter
4   Universitätsklinikum der FSU Jena, Klinik für Hals-, Nasen-, Ohrenheilkunde, Jena
,
O. Guntinas-Lichius
5   Universitätsklinikum der FSU Jena, Klinik für Hals-, Nasen-, Ohrenheilkunde, Jena
› Author Affiliations
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Publication History

Publication Date:
08 December 2015 (online)

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Zusammenfassung

Hintergrund: Die affektive Valenz eines Riechreizes wird in seiner respiratorischen Antwort kodiert. Unangenehme Gerüche verkürzen im Wach- und Schlafzustand die Dauer der Inspiration des ersten Reizatemzuges. Unter medikamentös induzierter Sedierung ist das bisher nicht untersucht worden.

Material und Methoden: 13 ASA 1/2-Patienten beiderlei Geschlechts wurden unter Überwachung der Vitalfunktionen während „tiefer“ (EEG-basierter Bispektraler Index: BIS≤60) bzw. „moderater“ (BIS>60) Sedierung mit Propofol bei erhaltener Spontanatmung chemosensorisch (H2S und CO2) inspirationssynchron über ein Fluss-Olfaktometer gereizt. Die Dauer der In- und Exspiration wurde für 5 Atemzüge vor und für 2 Atemzüge nach der Reizapplikation analysiert.

Ergebnisse: Im Sedierungsstadium BIS≤60 ließen sich nur mit CO2 respiratorische Reaktionen auslösen. Bei moderater Sedierung ließen sich auch mit H2S-Reizen Atemänderungen evozieren. Während einer moderaten Sedierung waren die durch eine CO2-Reizung bzw. durch eine H2S-Reizung ausgelösten respiratorischen Reaktionen häufiger mit ihrer Inspirationsdauer verlängert als verkürzt.

Schlussfolgerungen: Olfaktorische Reize verändern die Atmung nur während moderater Sedierung, trigeminale Reize evozieren Atemänderungen sowohl während moderater als auch tiefer Propofol-induzierter Sedierung. Im Gegensatz zum Wach- und Schlafzustand verlängert sich während moderater Sedierung bei einer H2S-Reizung häufig die Inspiration.

Abstract

Background: The affective valence of an olfactory stimulus will be encoded in its respiratory response. Unpleasant odors shorten the inhalation of the first stimulated breaths in wakefulness and sleep. The aim of the present study was to assess the effekt of intravenous anesthetic propofol on the chemosensory evoked changes of breathing pattern.

Material and methods: 13 ASA 1/2 patients got intranasal chemosensory stimuli (H2S and CO2) by flow-olfactometer during “deep” (EEG-based bispectral analysis, BIS:≤60) and “moderate” (BIS>60) propofol-induced sedation with preserved spontaneous breathing. The duration of the in- and exhalation was analyzed for 5 breaths before and for 2 breaths after the onset of stimulation.

Results: During deep sedation respiratory reactions were observed only by CO2 irritation. During moderate sedation respiratory responses were evoked by H2S stimuli, too. In moderate sedation extensions of the inhalations of the first breath after both the unpleasant pure olfactory H2S stimuli and the trigeminal stimuli were more frequent than reductions.

Conclusion: Olfactory stimuli change the breathing only during moderate sedation, trigeminal stimuli during deep and moderate propofol-induced sedation. In opposite to both wakefulness and sleep the duration of inhalation is often extended by H2S-stimuli during moderate sedation.

Schlüsselwörter

Riechen - Atemänderung - Sedierung - Propofol - EEG - affektive Valenz

Key words

smell - breathing pattern - sedation - propofol - EEG - affective valence
 

  • Literatur

  • 1 Gudziol H, Wajnert B, Forster G. How do pleasant and unpleasant odours change the breathing pattern?. Laryngorhinootologie 2006; 85: 567-572
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Frank RA, Gesteland RC, Bailie J, Rybalsky K, Seiden A, Dulay MF. Characterization of the sniff magnitude test. Arch Otolaryngol Head Neck Surg 2006; 132: 532-536
    CrossrefPubMedGoogle Scholar
  • 3 Stuck BA, Stieber K, Frey S, Freiburg C, Hormann K, Maurer JT, Hummel T. Arousal responses to olfactory or trigeminal stimulation during sleep. Sleep 2007; 30: 506-510
    CrossrefPubMedGoogle Scholar
  • 4 Arzi A, Sela L, Green A, Givaty G, Dagan Y, Sobel N. The influence of odorants on respiratory patterns in sleep. Chem Senses 2010; 35: 31-40
    CrossrefPubMedGoogle Scholar
  • 5 Arzi A, Shedlesky L, Ben-Shaul M, Nasser K, Oksenberg A, Hairston IS, Sobel N. Humans can learn new information during sleep. Nat Neurosci 2012; 15: 1460-1465
    CrossrefPubMedGoogle Scholar
  • 6 Arzi A, Holtzman Y, Samnon P, Eshel N, Harel E, Sobel N. Olfactory aversive conditioning during sleep reduces cigarette-smoking behavior. J Neurosci 2014; 34: 15382-15393
    CrossrefPubMedGoogle Scholar
  • 7 Arzi A, Rozenkrantz L, Holtzman Y, Secundo L, Sobel N. Sniffing patterns uncover implicit memory for undetected odors. Curr Biol 2014; 24: R263-R264
    CrossrefPubMedGoogle Scholar
  • 8 Van Aken H, Biermann E, Martin J. Entschließung zur Analgosedierung für diagnostische und therapeutische Verfahren bei Erwachsenen. Anästh Intensivmed 2010; 51: 598-602
    PubMedGoogle Scholar
  • 9 Hummel T, Kobal G, Gudziol H, Mackay-Sim A. Normative data for the “Sniffin’ Sticks” including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 2007; 264: 237-243
    CrossrefPubMedGoogle Scholar
  • 10 Adrian ED. Olfactory reactions in the brain of the hedgehog. J Physiol 1942; 100: 459-473
    CrossrefPubMedGoogle Scholar
  • 11 Gudziol V, Lotsch J, Hahner A, Zahnert T, Hummel T. Clinical significance of results from olfactory testing. Laryngoscope 2006; 116: 1858-1863
    CrossrefPubMedGoogle Scholar
  • 12 Laing DG. Characterisation of human behaviour during odour perception. Perception 1982; 11: 221-230
    CrossrefPubMedGoogle Scholar
  • 13 Gudziol H, Stark D, Lehnich H, Bitter T, Guntinas-Lichius O. Hyposmics have less evoked respiratory orienting reactions than normosmics. Laryngorhinootologie 2010; 89: 477-482
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Johnson BN, Russell C, Khan RM, Sobel N. A comparison of methods for sniff measurement concurrent with olfactory tasks in humans. Chem Senses 2006; 31: 795-806
    CrossrefPubMedGoogle Scholar
  • 15 Mainland J, Sobel N. The sniff is part of the olfactory percept. Chem Senses 2006; 31: 181-196
    PubMedGoogle Scholar
  • 16 Badia P, Wesensten N, Lammers W, Culpepper J, Harsh J. Responsiveness to olfactory stimuli presented in sleep. Physiol Behav 1990; 48: 87-90
    CrossrefPubMedGoogle Scholar
  • 17 Carskadon MA, Herz RS. Minimal olfactory perception during sleep: why odor alarms will not work for humans. Sleep 2004; 27: 402-405
    PubMedGoogle Scholar
  • 18 Ravesloot MJ, de Vries N. One hundred consecutive patients undergoing drug-induced sleep endoscopy: results and evaluation. Laryngoscope 2011; 121: 2710-2716
    CrossrefPubMedGoogle Scholar
  • 19 Ramsay MA, Newman KB, Jacobson RM, Richardson CT, Rogers L, Brown BJ, Hein HA, De Vol EB, Daoud YA. Sedation levels during propofol administration for outpatient colonoscopies. Proc (Bayl Univ Med Cent) 2014; 27: 12-15
    PubMedGoogle Scholar
  • 20 Bouillon T, Bruhn J, Radu-Radulescu L, Andresen C, Cohane C, Shafer SL. A model of the ventilatory depressant potency of remifentanil in the non-steady state. Anesthesiology 2003; 99: 779-787
    CrossrefPubMedGoogle Scholar
  • 21 Nieuwenhuijs DJ, Olofsen E, Romberg RR, Sarton E, Ward D, Engbers F, Vuyk J, Mooren R, Teppema LJ, Dahan A. Response surface modeling of remifentanil-propofol interaction on cardiorespiratory control and bispectral index. Anesthesiology 2003; 98: 312-322
    CrossrefPubMedGoogle Scholar
  • 22 Bouillon TW, Bruhn J, Radulescu L, Andresen C, Shafer TJ, Cohane C, Shafer SL. Pharmacodynamic interaction between propofol and remifentanil regarding hypnosis, tolerance of laryngoscopy, bispectral index, and electroencephalographic approximate entropy. Anesthesiology 2004; 100: 1353-1372
    CrossrefPubMedGoogle Scholar
  • 23 Yufune S, Takamatsu I, Masui K, Kazama T. Effect of remifentanil on plasma propofol concentration and bispectral index during propofol anaesthesia. Br J Anaesth 2011; 106: 208-214
    CrossrefPubMedGoogle Scholar
  • 24 Hickey KS, Martin DF, Chuidian FX. Propofol-induced seizure-like phenomena. J Emerg Med 2005; 29: 447-449
    CrossrefPubMedGoogle Scholar
  • 25 Iselin-Chaves IA, Flaishon R, Sebel PS, Howell S, Gan TJ, Sigl J, Ginsberg B, Glass PS. The effect of the interaction of propofol and alfentanil on recall, loss of consciousness, and the Bispectral Index. Anesthesia & Analgesia 1998; 87: 949-955
    PubMedGoogle Scholar
  • 26 Vasileiou I, Xanthos T, Koudouna E, Perrea D, Klonaris C, Katsargyris A, Papadimitriou L. Propofol: a review of its non-anaesthetic effects. Eur J Pharmacol 2009; 605: 1-8
    CrossrefPubMedGoogle Scholar
  • 27 Kroeger D, Amzica F. Hypersensitivity of the Anesthesia-Induced Comatose Brain. The Journal of Neuroscience 2007; 27: 10597-10607
    CrossrefPubMedGoogle Scholar
  • 28 Yli-Hankala A, Jantti V, Pyykko I, Lindgren L. Vibration stimulus induced EEG bursts in isoflurane anaesthesia. Electroencephalogr Clin Neurophysiol 1993; 87: 215-220
    CrossrefPubMedGoogle Scholar
  • 29 Hofbauer RK, Fiset P, Plourde G, Backman SB, Bushnell MC. Dose-dependent effects of propofol on the central processing of thermal pain. Anesthesiology 2004; 100: 386-394
    CrossrefPubMedGoogle Scholar
  • 30 Heinke W, Kenntner R, Gunter TC, Sammler D, Olthoff D, Koelsch S. Sequential effects of increasing propofol sedation on frontal and temporal cortices as indexed by auditory event-related potentials. Anesthesiology 2004; 100: 617-625
    CrossrefPubMedGoogle Scholar
  • 31 Gjerstad AC, Storm H, Hagen R, Huiku M, Qvigstad E, Ræder J. Skin conductance or entropy for detection of non-noxious stimulation during different clinical levels of sedation. Acta Anaesthesiologica Scandinavica 2007; 51: 1-7
    PubMedGoogle Scholar
  • 32 Haenggi M, Ypparila H, Takala J, Korhonen I, Luginbühl M, Petersen-Felix S, Jakob SM. Measuring depth of sedation with auditory evoked potentials during controlled infusion of propofol and remifentanil in healthy volunteers. Anesthesia & Analgesia 2004; 99: 1728-1736
    PubMedGoogle Scholar
  • 33 Hartikainen K, Rorarius M, Makela K, Perakyla J, Varila E, Jantti V. Visually evoked bursts during isoflurane anaesthesia. Br J Anaesth 1995; 74: 681-685
    CrossrefPubMedGoogle Scholar
  • 34 Makela K, Hartikainen K, Rorarius M, Jantti V. Suppression of F-VEP during isoflurane-induced EEG suppression. Electroencephalogr Clin Neurophysiol 1996; 100: 269-272
    CrossrefPubMedGoogle Scholar
  • 35 Murakami M, Kashiwadani H, Kirino Y, Mori K. State-dependent sensory gating in olfactory cortex. Neuron 2005; 46: 285-296
    CrossrefPubMedGoogle Scholar
  • 36 Samuelsson AR, Brandon NR, Tang P, Xu Y. Cellular registration without behavioral recall of olfactory sensory input under general anesthesia. Anesthesiology 2014; 120: 890-905
    CrossrefPubMedGoogle Scholar
  • 37 Bensafi M, Porter J, Pouliot S, Mainland J, Johnson B, Zelano C, Young N, Bremner E, Aframian D, Khan R, Sobel N. Olfactomotor activity during imagery mimics that during perception. Nat Neurosci 2003; 6: 1142-1144
    CrossrefPubMedGoogle Scholar
  • 38 Gottfried JA. Central mechanisms of odour object perception. Nat Rev Neurosci 2010; 11: 628-641
    CrossrefPubMedGoogle Scholar
  • 39 Lee U, Mashour GA, Kim S, Noh GJ, Choi BM. Propofol induction reduces the capacity for neural information integration: implications for the mechanism of consciousness and general anesthesia. Conscious Cogn 2009; 18: 56-64
    CrossrefPubMedGoogle Scholar