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

Area of Science:

• Veterinary Anesthesiology
• Surgical Complications
• Pharmacology

Background:

• Postoperative pneumonia is a frequent surgical complication.
• Airway protection is crucial for preventing aspiration.

Purpose of the Study:

• To investigate the impact of routine surgery and opioid administration on airway protection.
• To assess the risk of dysphagia and aspiration following surgical procedures.

Main Methods:

• Eight healthy adult cats were studied in two experiments.
• Airway protection and swallowing function were evaluated after abdominal surgery (spay) with low-dose buprenorphine.
• Cats received moderate or high doses of buprenorphine in a cross-over design.

Main Results:

• Significant airway protection deficits were observed in both experimental settings.
• Seventy-five percent of animals experienced silent aspiration, particularly in the postoperative period.
• Buprenorphine, a partial mu-opioid receptor agonist, was found to impair oropharyngeal swallow.

Conclusions:

• Buprenorphine impairs oropharyngeal swallow, especially after surgery.
• Findings suggest implications for preventing and managing aspiration pneumonia in susceptible patients.
• Routine surgery and opioid use increase the risk of airway protection compromise.