Effect of simulated ship motion on the anesthetic sensitivity of propofol in patients

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Author:
LI Jian-yu(Anesthesiology, No. 421 Hospital, CPLA , Guangzhou 510310, China)
WANG Yong()
WU Xin-wen(Anesthesiology, No. 421 Hospital, CPLA , Guangzhou 510310, China)
WANG Zhi-zhong(Anesthesiology, No. 421 Hospital, CPLA , Guangzhou 510310, China)
LIU Han(Anesthesiology, No. 421 Hospital, CPLA , Guangzhou 510310, China)
LIU Si-yang(Anesthesiology, No. 421 Hospital, CPLA , Guangzhou 510310, China)
LIU Rui-qin(Anesthesiology, No. 421 Hospital, CPLA , Guangzhou 510310, China)
Journal Title:
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
Issue:
Volume 19, Issue 04, 2012
DOI:
10.3760/cma.j.issn.1009-6906.2012.04.004
Key Word:
Simulated ship motion;Propofol;Entropy index;Vital signs;Rotating chair test

Abstract: Objective To explore the effect of simulated ship motion on the anesthetic sensitivity of propofol in patients,so as to provide cvidcncc for rational application of propofol during deployment at sea.Methods The motion sickness model was developed by using the rotating-chair test.Seventy-five cases of motion sickness were randomly divided into 5 groups,each consisting of 15.Of the 75 cases,60 were divided into the non-rotation and rotation groups.Then,each group was treated with a single injection of propofol and a single injection + continuous infusion of propofol.Thereby,2 anesthesia groups ( with anesthesia only,but no rotation) and 2 experimental groups (with rotation first,then anesthesia) were formed.In addition,a control group (with rotation only,but without anesthesia) was established.The determination of anesthetic sensitivity consisted of 2 parts:( 1 ) Dynamic changes in the vital signs and entropy indexes for the anesthesia and experimental groups were detected following injection of a single dose of propofol with the same dosage,and a comparison was made between them.(2)Hemodynamics and state entropy (SE) were maintained within 55% -60%,and then,infusion rate and serum concentration of propofol were compared between the anesthesia group and the experimental group.Results Following a single injection of propofol,SE and RE (response entropy) for the experimental group were all obviously lower than those of the anesthesia group.The time for the experimental group and the anesthesia group to reach the minimal SE value were (51.00 ± 12.36)s and (67.50 ± 14.72)s respectively,with that of the experimental group obviously being shorter,and statistical significance could be noted,when a comparison was made between the two (P < 0.01 ).For the experimental group,continuous infusion of propofol to maintain SE within 55%-60% for 30 min,an infusion rate of (3.36 ± 0.98) mg/( kg · h) and a serum propofol concentration of (2.95 ± 0.79 ) μg/ml were required.For the anesthesia group to reached the same state,an infusion rate of (5.38 ±0.84) mg/(kg · h ) and a serum propofol concentration of (4.41 ± 0.87) μg/ml were required respectively,with those of the experimental group obviously shorter,and statistical significance could be observed,when a comparison was made between the two (P < 0.01 ).The minimal infusion rates required by the experimental group and the anesthesia group were 2.00 mg/( kg · h) and 5.00 mg/( kg · h) respectively,with that of the experimental group obviously lower,and statistical significance could be observed,when a comparison was made between the two ( P <0.01 ).在 Patients in the control group displayed a prolonged dizziness and a shorter duration of somnolence.Ramsay’s sedative score decreased,with SE and RE respectively decreased to 66% and 52%.Conclusions Simulated ship motion could obviously help patients to tolerate propofol.Cerebral cortex inhibition induced by rotation might be one of the mechanisms involved.

  • [1]吴新文,李建玉,曹云飞,等,模拟航海运动病大鼠对异氟烷和七氟烷敏感性的变化,广东医学,2011,32(22):2932-2934.
  • [2]王林杰,裴静琛,孙洪义,等.Coriolis加速度刺激对人体动态姿态平衡的影响,中华航空航天医学杂志,2003,14(2):83-86.
  • [3]姜红,任耘,张索品,等.高效液相色谱-荧光法测定丙泊酚的血药浓度,天津医科大学学报,2007,13(1):58-60,85.
  • [4]吕东岭,陈晓虎,晕船病的心率变异性分析.实用心电学杂志,2010,19(2):115-117.
  • [5]Miller RD.Anesthesia.5th edn.New York:Churchill Livingstone,2001:253.
  • [6]鲁元.脑电熵指数在围麻醉期监测中的研究进展.内蒙古医学杂志,2011,43(4):457-459.
  • [7]王振元,李明颖,李洁,等.状态熵指数与靶控输注异丙酚时镇静深度及预测效应部位浓度的关系.山东大学学报(医学版),2007,45(8):838-841.
  • [8]张宏,毕索萍,贾宝森.熵指数监测在静脉麻醉诱导期中的应用.军医进修学院学报,2008,29(2):81-83.
  • [9]张惠,徐礼鲜,计根林,等,异丙酚麻醉时人脑内氨基酸递质水平的变化,华南国防医学杂志,2005,19(2):1-3,22.
  • [10]刘洋,廖大清,罗南富,等.七氟醚对吸入麻醉药敏感性不同的果蝇幼虫中枢神经元钾通道的影响,临床麻醉学杂志,2010,26(2):157-159.
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