Evidence map›Paper›PMID 37945413›Full record

ArticleBritish journal of anaesthesia2024

Opioid sensitivity in treated and untreated obstructive sleep apnoea: a prospective cohort study.

Michael C Montana, Michael McLeland, Marilee Fisher, Lindsay Juriga, Patrick M Ercole, Evan D Kharasch

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of anaesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02898792 (Opioid Sensitivity in Adults With Treated and Untreated Obstructive Sleep Apnea), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02898792 early_phase1completednot on this map

Opioid Sensitivity in Adults With Treated and Untreated Obstructive Sleep Apnea

TypeinterventionalSponsorWashington University School of MedicineRan2016 to 2018Enrolled77ConditionsApnea, SleepArmsTargeted infusion of remifentanil
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Michael C MontanaDepartment of Anesthesiology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA. Electronic address: montana@wustl.edu.
Michael McLelandSleep Laboratory, Saint Louis Children's Hospital, St. Louis, MO, USA.
Marilee FisherDepartment of Anesthesiology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA; Pediatric Intensive Care Unit, Saint Louis Children's Hospital, St. Louis, MO, USA.
Lindsay JurigaDepartment of Anesthesiology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA; University of Missouri School of Medicine, Columbia, MO, USA.
Patrick M ErcoleSansom Consulting, Pittsburgh, PA, USA.
Evan D KharaschDepartment of Anesthesiology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA; Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA.
St. Louis Children's Hospital · USWashington University in St. Louis · USDuke University · US

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
OPTIMIZING OUTPATIENT ANESTHESIA: IMPROVING ANALGESIA AND REDUCING OPIOID MISADVENTURER01DA042985 · NIDA · WASHINGTON UNIVERSITY · PI KHARASCH, EVAN D. · 2017 to 2021
$2.2M
NCATS NIH HHS UL1 TR002345NIDA NIH HHS R01 DA042985
6 · The paper itself

Abstract

backgroundOpioid administration to patients with obstructive sleep apnoea (OSA) is controversial because they are believed to be more sensitive to opioids. However, objective data on opioid effects in OSA are lacking. We tested the hypothesis that subjects with untreated OSA have increased sensitivity to opioids compared with subjects without OSA, or with OSA treated with continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP).

methodsThis was a single-centre, prospective cohort study in subjects without OSA (n=20), with untreated OSA (n=33), or with treated OSA (n=21). OSA diagnosis was verified using type III (in-home) polysomnography. Subjects received a stepped-dose remifentanil infusion (target effect-site concentrations of 0.5, 1, 2, 3, 4 ng ml

resultsThere were no differences in miosis between untreated OSA subjects (mean=0.51, 95% confidence interval [CI] 0.41-0.61) and subjects without OSA (mean=0.49, 95% CI 0.36-0.62) (mean difference=0.02, 95% CI -0.18 to 0.22); between treated OSA subjects (mean=0.56, 95% CI 0.43-0.68) and subjects without OSA (difference=0.07, 95% CI -0.16 to 0.29); or between untreated OSA and treated OSA (difference=-0.05, 95% CI -0.25 to 0.16). There were no significant differences between subjects without OSA, untreated OSA, and treated OSA in ventilatory rate, end-expired CO

conclusionsNeither obstructive sleep apnoea nor obstructive sleep apnoea treatment affected sensitivity to the miotic, sedative, analgesic, or respiratory depressant effects of the opioid remifentanil in awake adults. These results challenge conventional notions of opioid effects in obstructive sleep apnoea. CLINICAL

trial registrationNCT02898792 (clinicaltrials.gov).

Indexed as

Analgesics, OpioidSleep Apnea, ObstructiveAdultCarbon DioxideContinuous Positive Airway PressureHumansMiosisPainProspective StudiesRemifentanilAnalgesics, OpioidCarbon DioxideRemifentanilobstructive sleep apnoeaopioid sensitivityremifentanilrespiratory depressionthermal pain

Identifiers

PMID37945413
PMCPMC10797511
OpenAlexW4388449410

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.