Am. J. Respir. Crit. Care Med., Vol 155, No. 2, 02 1997, 459-465.
Airway anesthesia and respiratory adaptations to dead space loading and exercise
BS Krishnan, MJ Stockwell, RE Clemens and CG Gallagher
Department of Medicine, University of Saskatchewan, Saskatoon, Canada.
In exercising humans, added external dead space (VD) increases minute
ventilation (VI) and causes a slower and deeper breathing pattern (J. Appl.
Physiol. 1991; 70:55-62). Recent studies suggest that airway receptors
sensitive to topical anesthesia influence VI and breathing pattern
responses to exercise and to added VD. We tested these hypotheses with a
technique of airway anesthesia (Anesthesia) that has been shown to reliably
attenuate airway reflexes. Anesthesia was administered by local
laryngopharyngeal application and aerosolized lidocaine inhalation, and was
confirmed by citric acid aerosol inhalation challenges. Twelve normal males
performed maximal incremental cycle ergometer exercise on 4 d (randomized)
after Anesthesia with (Anesthesia VD) and without added VD (Anesthesia
Control) and after normal saline inhalation (Saline) with (Saline VD) and
without added VD (Saline Control). There were no differences in the VI and
breathing pattern responses during exercise between the Saline Control and
the Anesthesia Control tests. After both Saline and Anesthesia inhalation,
added VD resulted in an increase in VI both at rest and during exercise. At
matched VI (98 L/min), the differences in tidal volume (VT) between the
Saline Control and Saline VD tests (delta = 0.23 +/- 0.24 L, mean +/- SD)
and the Anesthesia Control and Anesthesia VD tests (delta = 0.20 +/- 0.28
L) were not significantly different. Our study had a power of greater than
95% to detect significant differences in VI or breathing pattern due to
Anesthesia. We conclude that in normal humans, airway receptors do not play
a major role in ventilation and breathing pattern control during exercise,
and that the respiratory adaptations to added VD during exercise are not
mediated by airway afferent reflexes.