Patients with obstructive sleep apnea are often said to have increased sensitivity to opioidinduced ventilatory depression. In this issue of Anesthesiology, Doufas et al. compared minute ventilation in 30 patients with moderate-to-severe obstructive sleep apnea and 20 controls with no to mild obstructive sleep apnea who received a brief remifentanil infusion during continuous monitoring of ventilation. Obstructive sleep apnea status did not influence the sensitivity to remifentanil-induced ventilatory depression in awake patients. In an accompanying Editorial View, Henthorn and Olofsen discuss the limitations that can be drawn from this economized pharmacokinetic–pharmacodynamic study.

  • Doufas et al.: Non–steady State Modeling of the Ventilatory Depressant Effect of Remifentanil in Awake Patients Experiencing Moderate-to-severe Obstructive Sleep Apnea, p. 213

  • Henthorn and Olofsen: Where’s the Beef? How Much Can We Skimp on Pharmacokinetic–Pharmacodynamic Data? p. 186