Dysphagia as a Missing Link Between Post-surgical- and Opioid-Related Pneumonia

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 determ...

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Bibliographic Details
Published in:Lung 2024-04, Vol.202 (2), p.179-187
Main Authors: Frazure, Michael, Greene, Clinton L., Iceman, Kimberly E., Howland, Dena R., Pitts, Teresa
Format: Article
Language:English
Subjects:
Analgesics, Opioid - adverse effects
Animals
Buprenorphine
Buprenorphine - adverse effects
Cat Diseases - chemically induced
Cats
Cross-Over Studies
Deglutition Disorders - etiology
Deglutition Disorders - veterinary
Dysphagia
DYSPHAGIA and PNEUMONIA
Female
Females
Male
Medicine
Medicine & Public Health
Narcotics
Opioid receptors (type mu)
Pneumology/Respiratory System
Pneumonia
Pneumonia - chemically induced
Pneumonia - complications
Pneumonia - veterinary
Respiratory tract
Surgery
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Summary: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.
ISSN:0341-2040
1432-1750
1432-1750
DOI:10.1007/s00408-024-00672-8