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Tactile stimulation of the oropharynx elicits sympathoexcitation in conscious humans
- Source :
- Journal of Applied Physiology. 115:71-77
- Publication Year :
- 2013
- Publisher :
- American Physiological Society, 2013.
-
Abstract
- Tactile stimulation of the oropharynx (TSO) elicits the gag reflex and increases heart rate (HR) and mean arterial pressure (MAP) in anesthetized patients. However, the interaction between upper-airway defense reflexes and the sympathetic nervous system has not been investigated in conscious humans. In Experiment 1, beat-by-beat measurements of HR, MAP, muscle sympathetic nerve activity (MSNA), and renal vascular resistance (RVR) were measured during TSO and tactile stimulation of the hard palate (Sham) in the supine posture. In Experiment 2, TSO was performed before (pre) and after (post) inhalation of 4% lidocaine via nebulizer. Rate pressure product (RPP) was determined. Compared with Sham, TSO elicited the gag reflex and increased RPP [absolute change (Δ)36 ± 6 vs. 17 ± 5%], MSNA (Δ122 ± 39 vs. 19 ± 19%), and RVR (Δ55 ± 11 vs. 4 ± 4%). This effect occurred within one to two cardiac cycles of TSO. The ΔMAP (12 ± 3 vs. 6 ± 1 mmHg) and the ΔHR (10 ± 3 vs. 3 ± 3 beats/min) were also greater following TSO compared with Sham. Lidocaine inhalation blocked the gag reflex and attenuated increases in MAP (Δpre: 16 ± 2; Δpost: 5 ± 2 mmHg) and HR (Δpre: 12 ± 3; Δpost: 2 ± 2 beats/min) in response to TSO. When mechanically stimulated, afferents in the oropharynx not only serve to protect the airway but also cause reflex increases in MSNA, RVR, MAP, and HR. An augmented sympathoexcitatory response during intubation and laryngoscopy may contribute to perioperative cardiovascular morbidity and mortality.
- Subjects :
- Adult
Male
Palate, Hard
Mean arterial pressure
Sympathetic nervous system
Sympathetic Nervous System
Supine position
Physiology
Oropharynx
Blood Pressure
Renal Circulation
Young Adult
Pharyngeal reflex
Heart Rate
Physical Stimulation
Tachycardia
Physiology (medical)
Reflex
Heart rate
Pressure
Humans
Medicine
Arterial Pressure
Anesthetics, Local
business.industry
Lidocaine
Articles
Cold Temperature
medicine.anatomical_structure
Rate pressure product
Data Interpretation, Statistical
Anesthesia
Hypertension
Vascular resistance
Female
Vascular Resistance
business
Subjects
Details
- ISSN :
- 15221601 and 87507587
- Volume :
- 115
- Database :
- OpenAIRE
- Journal :
- Journal of Applied Physiology
- Accession number :
- edsair.doi.dedup.....21008fc0bae2fdbc97654dc813c17d7d