Identification of independent predictors for intravenous thiopental-induced yawning

Abstract

Thiopental-induced yawning may be suppressed by female sex, prior use of intravenous fentanyl, and premedication with clonidine. These findings may allow insights into the physiologic and pharmacological aspects of yawning in humans, thereby leading to the development methods to prevent thiopental-induced yawning.

Inhibitory effects of landiolol and nicardipine on thiopental-induced yawning in humans

“…b-adrenoreceptors and opioid receptors, members of G-protein-coupled-receptor superfamily, are known to functionally and physically cross-talk via multiple hierarchical mechanisms, including heterodimerization of these receptors, counterbalance of functional opposing G-protein signaling, and interface at downstream signaling events [18]. On the other hand, the hypothetical mechanism by which IV-administered landiolol might suppress the thiopental-induced yawning response through an opioid mimetic/sparing effect is supported by our recent finding in humans that the probability of a thiopental-induced yawning response is decreased by prior use of IV-administered fentanyl [3]. Indeed, yawning is one of the commonest signs of opiate withdrawal syndrome in opiate addicts.…”

“…Without prior administration of an opioid, such as fentanyl, a yawning response may occur within 1 min after IV injection of thiopental or propofol (occurrence rate approximately 50%) [1][2][3]. Moreover, we recently demonstrated in humans that this type of yawning is associated with a transient arousal shift during continuing loss of consciousness [2].…”

Yawning and airway physiology: a scoping review and novel hypothesis

“…Two articles were obtained via the Utrecht University library [38,48]. The studies of Oshima (2007Oshima ( , 2010 and Tsou (2008Tsou ( , 2012 were written by the same authors. Most studies were incidence studies and had a level of evidence 2 according to the LEGEND table.…”

“…Pulmonary complications reduced significantly ↑ Yawns ⥬ ↓ Obstructive airway (↓ Yawns ⥬ ↑ Obstructive airway) Spirometer Evans (1978) [ 39 ] Case report 5b 2 case reports of chocking children in emergency setting with increased yawning Increased yawning while choking; decreased yawning after the obstruction was relieved Yawning might be stimulated by vagal feedback arising from the pharynx ↑ Obstructive airway ⥬ ↑ Yawns ↓ Obstructive airway ⥬ ↓ Yawns Mukai (1991) [ 40 ] Case series 4a 51 patients (age 3–59 weeks) with ankyloglossia were examined: O 2 measurements, fibroscopic examination of epiglottal, and laryngeal deviation. Frenotomy and correction of tongue, epiglottis, and larynx if necessary More frequent yawning in epiglottal and laryngeal deviation and when O 2 levels dropped ↑ Obstructive airway ⥬ ↑ Yawns Ankyloglossia sleepiness Kim (2002) [ 41 ] Randomized observational clinical study 2a 60 healthy adult patients were induced in anesthesia with thiopental ( n = 30) and propofol ( n = 30) and all patients were observed (verbal response, eye-lash reflex yawning, apnea) before intubation During induction, 83% of thiopental patients and 63% of propofol patients yawned before intubation ↑ Obstructive airway ⥬ ↑ Yawns Propofol, thiopental, sleepiness Kasuya (2005) [ 42 ] Prospective cohort 2a 60 patients ASA 1 / 2 undergoing elective surgery induced thiopental and propofol, together with atropine and hydroxyzine hydrochloride During induction 60% of thiopental patients and 47% propofol patients yawned ↑ Obstructive airway ⥬ ↑ Yawns Propofol, thiopental, sleepiness Oshima (2007) [ 43 ] Retrospective cohort 3a 1322 patients undergoing elective surgery, thiopental, yawning response in...…”