The primary reason for death after opiate usage is breathing problems. In the UK, there were 140,863 adults seeking treatment for opioid use in 2020–2021, and opioid use is still a leading cause of preventable mortality, accounting for 3,726 drug-related fatalities in 2017. Misuse of opioids suppresses respiratory function, which results in mortality.
A new treatment for opioid-related respiratory depression that delivers electrical pulses to the back of the neck may help patients restore respiratory control after using high doses of opioids, according to new research that was just published in The Journal of Physiology.
This may provide an alternative to pharmaceutical treatments, which can have adverse effects on the central nervous system, produce withdrawal symptoms, and heart difficulties. Because opioids desensitize the brain stem to increases in carbon dioxide, breathing issues may develop after opioid use or as a result of post-operative difficulties from anesthesia.
Respiratory failure from this has the potential to be lethal. The challenge of enabling patients to breathe independently remains despite the success of current treatments including manual lung expansion and medicines in the short term.
This new study offers an alternate, non-pharmacological treatment by using epidural electrical stimulation (EES).
Our results provide proof of principle that cervical EES could improve respiration following opioid use. We can compare the human body to a car, our goal is to jump-start the body so it can run by itself without periodic pushes. We hope to use EES to provide novel approaches to restore breathing for healthcare providers as we are now using defibrillation devices for restoring cardiac activities.
Dr. Daniel Lu
A network of neurons in the brainstem are stimulated when EES is applied at the cervical spinal cord, which is at the back of the neck. This network of neurons enhances the rate and depth of breathing by stimulating and coordinating the respiratory muscles.
In 18 patients with degenerative spine illnesses who were put under anesthesia for surgical treatment, researchers from the David Geffen School of Medicine at the University of California (UCLA), Los Angeles, US, focused on sensory-motor circuits in the cervical spinal cord. They continually applied 30 Hertz of EES for no more than 90 seconds to the cervical spinal cord.
They discovered that short bursts of continuous low-intensity EES not only enhanced breath volume but also actively controlled frequency and rhythm during breathing issues brought on by opioids. When the EES ended in the presence of high doses of opioids, the rhythmic breathing pattern persisted for a brief period of time.
Dr. Daniel Lu, senior author, and UCLA professor, and vice chair of neurosurgery, said:
“Our results provide proof of principle that cervical EES could improve respiration following opioid use. We can compare the human body to a car, our goal is to jump-start the body so it can run by itself without periodic pushes. We hope to use EES to provide novel approaches to restore breathing for healthcare providers as we are now using defibrillation devices for restoring cardiac activities.”
It will be determined whether EES can lessen or eliminate the requirement for ventilator support in acute pathological diseases such OIRD, stroke, and traumatic brain, brain stem, or spinal cord injury by the conduct of future trials in humans with bigger cohorts. In order to learn more about the function that particular neurons perform in response to EES, experimental research will be conducted in mice.
