Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of inhalation of 100 breaths of bupivacaine hydrochloride (5 percent solution in saline) on the cough reflex, the Breuer-Hering inflation, reflex, and the duration of apnea and bronchoconstriction produced by histamine aerosol were studied in nine anesthetized dogs. Cough was abolished in every animal; the duration of the inflation reflex was shortened from 47 +/- 4.6 s (mean plus or minus SE) to 16 +/- 3.4 s. The duration apnea produced by histamine was abolished or shortened and the rise in resistance was diminished from 170 plus or minus 22 per cent (control) to 49 +/- 6 per cent (after bupivacaine). These reflexes returned toward control values within 45 min. Bupivacaine inhibited the bronchoconstriction produced by electrical stimulation of the distal ends of cut vagus nerves both in dogs and in rabbits, but it did not alter the rise in resistance produced by histamine aerosol in vagotomized dogs. We conclude that administration of bupivacaine aerosol produces a reversible blockage of both afferent and efferent nervous activity in airways without abolishing the ability of smooth muscles to contract.
 ...
PMID:Inhibition of respiratory reflexes by local anesthetic aerosols in dogs and rabbits. 114 Nov 17

Seventy-five patients scheduled for major abdominal operations were randomly divided into four groups, each with a different postoperative analgesic regime. Group I: buprenorphine 4 micrograms/kg was injected i.v. every 4 h. Groups II-IV: all patients were preoperatively supplied with a thoracic epidural catheter that, however, was not used during the operation. Group II: bupivacaine 0.15 ml/kg was injected epidurally every 2 h, the first dose being 0.5%, the top-ups 0.25%. Group III: buprenorphine 4 micrograms/kg in 10 ml saline was given via the catheter and repeated on request. Group IV: these patients received a combined regime. Bupivacaine was injected as in group II, and in addition buprenorphine was added epidurally in the doses and time intervals of group I. After extubation the patients categorized the intensity of postoperative pain twice, first while lying immobile and then after coughing vigorously, using a rating scale with pain scores from 0 to 10. Thereafter, the analgesic regime described above commenced. One hour later the patients' pain scores were again determined. In addition to pain scores, heart rate (HR), mean arterial pressure (MAP) and paCO2 were recorded at the same points in time. The investigation was then interrupted overnight. The analgesic regime continued as described for groups I and II. Patients in group III received 0.15 mg buprenorphine on request i.v., and in group IV bupivacaine was given as in group II with no further buprenorphine. The study recommenced the next morning at 7:00 a.m. After the initial values (pain scores, HR, MAP, paCO2) had been recorded the analgesic program, as scheduled for each patient, restarted. In group IV buprenorphine was again added to bupivacaine and repeated every 4 h, whereas bupivacaine was injected every 2 h. All values were registered hourly until 7:00 p.m., when the investigation was terminated. RESULTS. On the day of operation and during the first few hours on the morning thereafter, analgesia in groups II and IV was considerably better compared to groups I and III (P less than 0.001). We could not statistically demonstrate, however, that analgesia in group IV was superior to that in group II despite the fact that pain scores were lowest in this group, with a median at rest of 0 throughout the study time. In group III (n = 20), epidural buprenorphine failed to produce any acceptable analgesic effect in 6 patients despite correct catheter position. For this reason they were dropped from the study. No patient in any of the other groups, however, was dropped (P less than 0.01). Later in the 1st postoperative day analgesia in groups II and IV lost its superiority at rest, but coughing continued to be less painful in comparison to groups I and III. We noticed that the duration of action of 0.25% bupivacaine, injected as a bolus, was considerably shorter than expected (less than 2 h) and that several patients experienced pain before the next top-up was given...
 ...
PMID:[Postoperative peridural analgesia via catheter following abdominal surgery. Peridural bupivacaine versus buprenorphine]. 219 6

The effect on ventilation of airway anaesthesia, produced by the inhalation of a 5% bupivacaine aerosol (aerodynamic mass median diameter = 4.77 micron), was studied in 12 normal subjects. The dose and distribution of the aerosol were determined from lung scans after the addition to bupivacaine of 99mTc. Bupivacaine labelled in this way was deposited primarily in the central airways. The effectiveness and duration of airway anaesthesia were assessed by the absence of the cough reflex to the inhalation of three breaths of a 5% citric acid aerosol. Airway anaesthesia always lasted more than 20 min. Resting ventilation was measured, by respiratory inductance plethysmography, before and after inhalation of saline and bupivacaine aerosols. The ventilatory response to maximal incremental exercise and, separately, to CO2 inhalation was studied after the inhalation of saline and bupivacaine aerosols. Breathlessness was quantified by using a visual analogue scale (VAS) during a study and by questioning on its completion. At rest, airway anaesthesia had no effect on mean tidal volume (VT), inspiratory time (Ti), expiratory time (Te) or end-tidal PCO2, although the variability of tidal volume was increased. On exercise, slower deeper breathing was produced and breathlessness was reduced. The ventilatory response to CO2 was increased. The results suggest that stretch receptors in the airways modulate the pattern of breathing in normal man when ventilation is stimulated by exercise; their activation may also be involved in the genesis of the associated breathlessness. A hypothesis in terms of a differential airway/alveolar receptor block, is proposed to explain the exaggerated ventilatory response to CO2.
 ...
PMID:The effect of airway anaesthesia on the control of breathing and the sensation of breathlessness in man. 391 83