Neuroanatomical and pharmaco-physiological effects of hypoxia and esketamine on breathing, the sympathetic nerve system, and cortical function
Issued Date
2024-01-01
Resource Type
ISSN
00070912
eISSN
14716771
Scopus ID
2-s2.0-85212322582
Journal Title
British Journal of Anaesthesia
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SCOPUS
Bibliographic Citation
British Journal of Anaesthesia (2024)
Suggested Citation
Suleiman A., Wongtangman K., Eikermann M., Stucke A.G. Neuroanatomical and pharmaco-physiological effects of hypoxia and esketamine on breathing, the sympathetic nerve system, and cortical function. British Journal of Anaesthesia (2024). doi:10.1016/j.bja.2024.11.011 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102479
Title
Neuroanatomical and pharmaco-physiological effects of hypoxia and esketamine on breathing, the sympathetic nerve system, and cortical function
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Author's Affiliation
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Abstract
Acute hypoxic ventilatory response is an important reflex that helps maintain breathing during low oxygen levels, but it is attenuated by most general anaesthetics. Analgesic doses of ketamine and esketamine are known to have respiratory stimulant effects. In their recent study in the British Journal of Anaesthesia, Jansen and colleagues show that low-dose esketamine preserved the acute hypoxic ventilatory response, while increasing breathing rate, systolic blood pressure, and heart rate. Participants also exhibited higher levels of alertness and unpleasant psychotropic effects compared with the control condition. We review the pharmaco-physiological effects of acute hypoxia and its interactions with esketamine. We provide a summary of the effects of hypoxia and esketamine on the neurocircuitry that leads to arousal, activation of the sympathetic nerve system, and increased drive to upper airway dilator and respiratory pump muscles.