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.

中文翻译：

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吞咽困难是术后和阿片类药物相关肺炎之间缺失的环节

目的

尽管越来越受到关注，术后肺炎仍然是手术的常见并发症。我们研究的目的是确定常规手术和术后阿片类药物给药对气道保护风险的影响。

方法

在两项实验中对八只健康成年猫进行了评估，以确定气道保护状态的变化和吞咽困难的证据。 (1) 在四只雌性猫中，在常规腹部手术（绝育手术）加低剂量阿片类药物给药（丁丙诺啡 0.015 mg/kg，肌肉注射，每 8-12 小时一次；n  = 5）后跟踪气道保护状态。 (2) 采用交叉设计，四只幼猫（2只雄性，2只雌性）接受中剂量（0.02 mg/kg）或高剂量（0.04 mg/kg）丁丙诺啡（IM，q8-12 h）治疗；n  = 5)。

结果

两项实验中的气道保护均受到显着影响，但最严重的缺陷发生在手术后，因为 75% 的动物表现出无声误吸。

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。这些发现对于弱势人群吸入性肺炎的预防和管理具有重要意义。