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

Abstract

Prior intravenous administration of either a Ca(2+)-channel blocker or a beta(1)-adrenoceptor antagonist can greatly reduce the thiopental-induced yawning response in humans.

Yawning and airway physiology: a scoping review and novel hypothesis

“…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 461. Inhibited yawning response by thiopental + fentanyl ( n = ~ 450), female sex, clonidine During induction, around 50% of thiopental-induced patients (not treated with fentanyl) yawned ↑ Obstructive airway ⥬ ↑ Yawns Propofol, thiopental, sleepiness Tsou (2008) [ 44 ] Prospective cohort 2a 546 ASA 1 / 2 patients undergoing elective surgery, induced with propofol only ( n = 386), propofol with atropine ( n = 90), and propofol with fentanyl ( n = 50) During induction, yawning occurred in 54% (propofol), 61% (propofol + atropine), and 0% (propofol + fentanyl) ↑ Obstructive airway ⥬ ↑ Yawns Propofol, sleepiness Oshima (2010) [ 45 ] RCT …”

“Optoanesthesia”: The Application of Transcranial Photobiomodulation to General Anesthesia

“…Yawning during the intravenous induction of general anesthesia with thiopental or propofol indicates a transient arousal-shift during the continuing loss of consciousness [57]. Such yawning responses may occur one minute after the injection of thiopental or propofol, with an occurrence rate of approximately 50% [58]. Upper-airway collapse during the induction of anesthesia coincides with increased yawning, while upper-airway muscle dilation and decreased yawning caused either by either teeth clenching or opioids administrations coincides with obstructive sleep apnea-like symptoms [59].…”