Anesthesiology
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Although respiratory depression is the most well-known and dangerous side effect of opioids, no pharmacokinetic-pharmacodynamic model exists for its quantitative analysis. The development of such a model was the aim of this study. ⋯ The model described the data for the entire opioid-PaCo2 response surface examined. Indirect response models appear to be a promising tool for the quantitative evaluation of drug-induced respiratory depression.
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Insertion of a gastric tube (GT) in anesthetized, paralyzed, and intubated patients can be difficult The purpose of this study was to determine fiberoptically why GTs succeed or fail to enter the esophagus and, based on these findings, to determine a mechanism for converting failures into successes. ⋯ GTs enter the hypopharynx just lateral to the arytenoid cartilages. Consequently, the most common sites of resistance at the laryngeal level are the arytenoid cartilages and piriform sinuses. Lateral neck pressure compresses the piriform sinuses and moves the arytenoid cartilages medially, relieving 85% of these GT impactions.