{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T01:32:42Z","timestamp":1722562362671},"reference-count":57,"publisher":"American Physiological Society","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2013,7,1]]},"abstract":"<jats:p> Tactile stimulation of the oropharynx (TSO) elicits the gag reflex and increases heart rate (HR) and mean arterial pressure (MAP) in anesthetized patients. However, the interaction between upper-airway defense reflexes and the sympathetic nervous system has not been investigated in conscious humans. In Experiment 1, beat-by-beat measurements of HR, MAP, muscle sympathetic nerve activity (MSNA), and renal vascular resistance (RVR) were measured during TSO and tactile stimulation of the hard palate (Sham) in the supine posture. In Experiment 2, TSO was performed before (pre) and after (post) inhalation of 4% lidocaine via nebulizer. Rate pressure product (RPP) was determined. Compared with Sham, TSO elicited the gag reflex and increased RPP [absolute change (\u0394)36 \u00b1 6 vs. 17 \u00b1 5%], MSNA (\u0394122 \u00b1 39 vs. 19 \u00b1 19%), and RVR (\u039455 \u00b1 11 vs. 4 \u00b1 4%). This effect occurred within one to two cardiac cycles of TSO. The \u0394MAP (12 \u00b1 3 vs. 6 \u00b1 1 mmHg) and the \u0394HR (10 \u00b1 3 vs. 3 \u00b1 3 beats\/min) were also greater following TSO compared with Sham. Lidocaine inhalation blocked the gag reflex and attenuated increases in MAP (\u0394pre: 16 \u00b1 2; \u0394post: 5 \u00b1 2 mmHg) and HR (\u0394pre: 12 \u00b1 3; \u0394post: 2 \u00b1 2 beats\/min) in response to TSO. When mechanically stimulated, afferents in the oropharynx not only serve to protect the airway but also cause reflex increases in MSNA, RVR, MAP, and HR. An augmented sympathoexcitatory response during intubation and laryngoscopy may contribute to perioperative cardiovascular morbidity and mortality. <\/jats:p>","DOI":"10.1152\/japplphysiol.00197.2013","type":"journal-article","created":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T02:25:18Z","timestamp":1366338318000},"page":"71-77","source":"Crossref","is-referenced-by-count":8,"title":["Tactile stimulation of the oropharynx elicits sympathoexcitation in conscious humans"],"prefix":"10.1152","volume":"115","author":[{"given":"Matthew D.","family":"Muller","sequence":"first","affiliation":[{"name":"Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, Pennsylvania; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L.","family":"Mast","sequence":"additional","affiliation":[{"name":"Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, 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