{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T21:17:25Z","timestamp":1781817445220,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Obstructive sleep apnea is a risk factor for respiratory depression following opioid administration as well as opioid\u2010induced hyperalgesia. Little is known on how obstructive sleep apnea status is associated with central ventilatory depression in pediatric surgical patients given a single dose of fentanyl.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center, prospective trial in children undergoing surgery requiring intubation and opioid administration. Sixty patients between the ages of 2\u20138\u00a0years presenting for surgery at Texas Children's Hospital were recruited. Twenty non\u2010obstructive sleep apnea controls and 30 patients with moderate to severe obstructive sleep apnea met inclusion criteria. Following induction of general anesthesia and establishment of steady\u2010state ventilation, participants received 1\u00a0mcg\/kg intravenous fentanyl. Ventilatory variables (tidal volume, respiratory rate, end\u2010tidal CO<jats:sub>2<\/jats:sub>, and minute ventilation) were assessed each minute for 10\u00a0min. The primary outcome was the extent of opioid\u2010induced central ventilatory depression over time by obstructive sleep apnea status when compared with baseline values. Secondary aims assessed the impact of demographics and SpO<jats:sub>2<\/jats:sub> nadir on ventilatory depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found no significant difference in percent decrease in respiratory rate (38.1% and 37.1%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.950), tidal volume (6.4% and 5.4%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.992), and minute ventilation (35.0\u00a0L\/min and 35.0\u00a0L\/min; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.890) in control and obstructive sleep apnea patients, respectively. Both groups experienced similar percent increases in end\u2010tidal CO<jats:sub>2<\/jats:sub> (4.0% vs. 2.2%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.512) in control and obstructive sleep apnea patients, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In pediatric surgical patients, obstructive sleep apnea status was not associated with significant differences in central respiratory depression following a single dose of fentanyl (1\u00a0mcg\/kg). These findings can help determine safe opioid doses in future pediatric obstructive sleep apneapatients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14228","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T08:39:48Z","timestamp":1622795988000},"page":"977-984","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["An assessment of opioids on respiratory depression in children with and without obstructive sleep apnea"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6518-1549","authenticated-orcid":false,"given":"Adam C.","family":"Adler","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine Texas Children's Hospital Houston TX USA"},{"name":"Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-4949","authenticated-orcid":false,"given":"Arvind","family":"Chandrakantan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine Texas Children's Hospital Houston TX USA"},{"name":"Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Nathanson","sequence":"additional","affiliation":[{"name":"OptiStatim LLC Longmeadow MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-8541","authenticated-orcid":false,"given":"Britta S.","family":"von Ungern\u2010Sternberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management Perth Children's Hospital Perth WA Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine The University of Western Australia Perth WA Australia"},{"name":"Telethon Kid's Institute Perioperative Medicine Team Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.2192"},{"issue":"8","key":"e_1_2_9_3_1","first-page":"S31","article-title":"Sleep disorders in children","volume":"199","author":"Waters KA","year":"2013","journal-title":"Med J Aust"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950160208"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13855"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet371"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200809-1392OC"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.05.029"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.9.1145"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182a951fc"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000265"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2607"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200610000-00009"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200610000-00017"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002430"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23455"},{"issue":"6","key":"e_1_2_9_17_1","first-page":"345","article-title":"Physiological responses to endotracheal and oral suctioning in paediatric patients: the influence of endotracheal tube sizes and suction pressures","volume":"2","author":"Singh NC","year":"1991","journal-title":"Clin Intensive Care"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00619.2001"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1569-9048(02)00034-4"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0361-9230(02)00915-2"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000244318.77377.67"},{"key":"e_1_2_9_22_1","unstructured":"Administration UFaD. 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