Am. J. Respir. Crit. Care Med.,
Volume 156, Number 1, July 1997, 309-313
Nasal Inhalation of l-menthol Reduces Respiratory
Discomfort Associated with Loaded Breathing
TAKASHI
NISHINO,
YUGO
TAGAITO,
and
YASUYOSHI
SAKURAI
Department of Anesthesiology, School of Medicine, Chiba University
To test the hypothesis that stimulation of cold receptors in the upper airway may alleviate the sensation of respiratory discomfort, we investigated the effects of nasal inhalation of l-menthol (a specific
stimulant of cold receptors) on the respiratory sensation and ventilation during the loaded breathing
in 11 normal subjects. Subjects were asked to rate their sensation of respiratory discomfort using a visual analog scale (VAS) while breathing on a device with a flow-resistive load (180 cm H2O/L/s) or
with an elastic load (75.5 cm H2O/L). The effects of inhalation of l-menthol on ventilation and respiratory sensation were evaluated by comparing the steady-state values of ventilatory variables and VAS
scores obtained before, during, and after l-menthol inhalation. In 8 of 11 subjects inhalation of strawberry-flavored air instead of l-menthol was performed during loaded breathing. Both during the flow-resistive loading and the elastic loading, inhalation of l-menthol caused a significant reduction
in sensation of respiratory discomfort (flow-resistive loading: 62 ± 14 [mean ± SD] VAS units before
inhalation versus 36 ± 16 during inhalation, p < 0.01; elastic loading: 68 ± 13 before inhalation versus 55 ± 17 during inhalation, p < 0.01) without a significant change in breathing pattern and ventilation. Comparison of the effects between the flow-resistive loading and the elastic loading also revealed that the reduction in VAS score was more during the flow-resistive loading than during the
elastic loading (p < 0.01). Inhalation of strawberry-flavored air caused neither changes in VAS score nor changes in breathing pattern and ventilation, indicating that olfaction is not a contributing factor in the relief of respiratory discomfort. We concluded that stimulation of cold receptors in the upper airway with nasal inhalation of l-menthol reduces the sensation of respiratory discomfort associated with loaded breathing. This effect is more effective during the flow-resistive loading than during
the elastic loading.