Key result
Fentanyl slows respiratory rhythm by prolonging bulbospinal neuron discharges without altering peak membrane depolarization.
Fentanyl slows respiratory rhythm via temporal changes in medullary respiratory neurons, likely driven by upstream bulbar respiratory neurons rather than direct membrane effects.
Extends animal-model insights into opioid respiratory slowing; leaves open translation to human opioid-induced respiratory depression.
Opiates have effects on respiratory neurons that depress tidal volume and air exchange, reduce chest wall compliance, and slow rhythm. The most dose-sensitive opioid effect is slowing of the respiratory rhythm through mechanisms that have not been thoroughly investigated. An in vivo dose-response analysis was performed on medullary respiratory neurons of adult cats to investigate two untested hypotheses related to mechanisms of opioid-mediated rhythm slowing: 1) Opiates suppress intrinsic conductances that limit discharge duration in medullary inspiratory and expiratory neurons, and 2) opiates delay the onset and lengthen the duration of discharges postsynaptically in phase-regulating postinspiratory and late-inspiratory neurons. In anesthetized and unanesthetized decerebrate cats, a threshold dose (3 microg/kg) of the mu-opioid receptor agonist fentanyl slowed respiratory rhythm by prolonging discharges of inspiratory and expiratory bulbospinal neurons. Additional doses (2-4 microg/kg) of fentanyl also lengthened the interburst silent periods in each type of neuron and delayed the rate of membrane depolarization to firing threshold without altering synaptic drive potential amplitude, input resistance, peak action potential frequency, action potential shape, or afterhyperpolarization. Fentanyl also prolonged discharges of postinspiratory and late-inspiratory neurons in doses that slowed the rhythm of inspiratory and expiratory neurons without altering peak membrane depolarization and hyperpolarization, input resistance, or action potential properties. The temporal changes evoked in the tested neurons can explain the slowing of network respiratory rhythm, but the lack of significant, direct opioid-mediated membrane effects suggests that actions emanating from other types of upstream bulbar respiratory neurons account for rhythm slowing.
No takes yet. Share an insight, caveat, or question.
Peter M. Lalley (2005) studied this question. Fentanyl was evaluated on Respiratory rhythm slowing and discharge prolongation of inspiratory and expiratory bulbospinal neurons. Fentanyl slowed respiratory rhythm by prolonging discharges of inspiratory and expiratory bulbospinal neurons without altering peak membrane depolarization, suggesting upstream mechanisms.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: