de Larminat V, Dureuil B
Département d'Anesthésie-Réanimation Chirurgicale, Hôpital Bichat, Paris.
Ann Fr Anesth Reanim. 1994;13(1):49-56. doi: 10.1016/s0750-7658(94)80186-x.
The swallowing reflex is one of the major mechanisms protecting the lungs against aspiration of foreign material. Its complex time course requires a perfect coordination with ventilation, as the aerodigestive crossroads are common for both functions. Physiological factors as ageing, as well as mechanical and pharmacological agents, may contribute to swallowing reflex alterations. Moreover, endotracheal intubation and most anaesthetic agents may impair the swallowing function and favour the occurrence of aspiration. This review discusses the normal swallowing process and its alterations by agents currently used in anaesthesia. Furthermore, the effect of intubation as well as changes related to co-existing diseases are considered.
吞咽反射是保护肺部免受异物误吸的主要机制之一。其复杂的时间进程需要与通气完美协调,因为气道消化道交叉区域是这两种功能的共同部位。诸如衰老等生理因素以及机械和药物因素,都可能导致吞咽反射改变。此外,气管插管和大多数麻醉剂可能损害吞咽功能并增加误吸的发生几率。本文综述了正常吞咽过程以及目前麻醉中使用的药物对其的影响。此外,还考虑了插管的影响以及与并存疾病相关的变化。