The effect of airway anaesthesia on the control of breathing and the sensation of breathlessness in man

A. J. Winning, R. D. Hamilton, Steven Shea, C. Knott, A. Guz

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

The effect on ventilation of airway anaesthesia, produced by the inhalation of a 5% bupivacaine aerosol (aerodynamic mass median diameter = 4.77 μm), 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 (V(T)), inspiratory time (T(i)), expiratory time (T(e)) or end-tidal P(CO2), 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.

Original languageEnglish (US)
Pages (from-to)215-225
Number of pages11
JournalClinical Science
Volume68
Issue number2
StatePublished - 1985
Externally publishedYes

Fingerprint

Bupivacaine
Aerosols
Dyspnea
Respiration
Anesthesia
Inhalation
Ventilation
Tidal Volume
Exercise
Inhalation Anesthesia
Mechanoreceptors
Plethysmography
Visual Analog Scale
Cough
Citric Acid
Reflex
Lung

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The effect of airway anaesthesia on the control of breathing and the sensation of breathlessness in man. / Winning, A. J.; Hamilton, R. D.; Shea, Steven; Knott, C.; Guz, A.

In: Clinical Science, Vol. 68, No. 2, 1985, p. 215-225.

Research output: Contribution to journalArticle

Winning, A. J. ; Hamilton, R. D. ; Shea, Steven ; Knott, C. ; Guz, A. / The effect of airway anaesthesia on the control of breathing and the sensation of breathlessness in man. In: Clinical Science. 1985 ; Vol. 68, No. 2. pp. 215-225.
@article{c9b0d6fc606f489e9419357f17f25a72,
title = "The effect of airway anaesthesia on the control of breathing and the sensation of breathlessness in man",
abstract = "The effect on ventilation of airway anaesthesia, produced by the inhalation of a 5{\%} bupivacaine aerosol (aerodynamic mass median diameter = 4.77 μm), 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 (V(T)), inspiratory time (T(i)), expiratory time (T(e)) or end-tidal P(CO2), 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.",
author = "Winning, {A. J.} and Hamilton, {R. D.} and Steven Shea and C. Knott and A. Guz",
year = "1985",
language = "English (US)",
volume = "68",
pages = "215--225",
journal = "Clinical Science",
issn = "0143-5221",
publisher = "Portland Press Ltd.",
number = "2",

}

TY - JOUR

T1 - The effect of airway anaesthesia on the control of breathing and the sensation of breathlessness in man

AU - Winning, A. J.

AU - Hamilton, R. D.

AU - Shea, Steven

AU - Knott, C.

AU - Guz, A.

PY - 1985

Y1 - 1985

N2 - The effect on ventilation of airway anaesthesia, produced by the inhalation of a 5% bupivacaine aerosol (aerodynamic mass median diameter = 4.77 μm), 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 (V(T)), inspiratory time (T(i)), expiratory time (T(e)) or end-tidal P(CO2), 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.

AB - The effect on ventilation of airway anaesthesia, produced by the inhalation of a 5% bupivacaine aerosol (aerodynamic mass median diameter = 4.77 μm), 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 (V(T)), inspiratory time (T(i)), expiratory time (T(e)) or end-tidal P(CO2), 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.

UR - http://www.scopus.com/inward/record.url?scp=0021948951&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021948951&partnerID=8YFLogxK

M3 - Article

VL - 68

SP - 215

EP - 225

JO - Clinical Science

JF - Clinical Science

SN - 0143-5221

IS - 2

ER -