Reducing respiratory depression without affecting anaesthesia

Propofol is one of the most commonly used agents for the induction and maintenance of general anaesthesia. It is a safe drug, but one of its drawbacks is suppression of normal ventilation, leading to apnoea. Now, that problem could soon be a thing of the past, thanks to a new drug which was recently tested in healthy participants. Dr Philip Kremer, Research Director Neurology: 'In LUMC's Anaesthesiology laboratory, we have shown in healthy subjects that this new drug leads to improved ventilation, without affecting the depth of overall anaesthesia.'

An important element in the regulation of breathing is the chemoreceptors in the carotid arteries that measure the amount of carbon dioxide and oxygen in the blood. If these chemoreceptors sense excessive levels of carbon dioxide or insufficient levels of oxygen, they send a signal to the respiratory centres in the brain, stimulating ventilation. The drug under study stimulates one of the pathways in the chemoreceptors. In other words, it enhances the stimulus to start breathing. This proves to be enough to counteract some of the unwanted effects of propofol on respiration. This compound could therefore contribute to the safety of propofol applications in anaesthesia and may also be useful in other situations where apnoea occurs.