Tung A, Lynch J P, Mendelson W B
Department of Anesthesia and Critical Care, The University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
Anesth Analg. 2001 May;92(5):1232-6. doi: 10.1097/00000539-200105000-00028.
The use of propofol provides sedation without prolonging emergence in patients in the Intensive Care Unit. When prolonged, however, continuous sedation may overlap with naturally occurring sleep periods and potentially increase the risk of sleep deprivation. We modified an established rat model of sleep to determine whether prolonged, continuous sedation results in sleep deprivation. Rats were continuously sedated for a 12-h period overlapping completely with their normal sleep phase. Electroencephalogram (EEG) and movement data were collected before and after the sedation period. Rats were evaluated for EEG and movement evidence of sleep deprivation after sedation. When compared with baseline, the time spent in rapid eye movement (REM) and non-REM sleep was decreased during the first 4 h after sedation. The duration of non-REM sleep bouts was not altered. Power in the delta band (0.5-4 Hz) during non-REM sleep was diminished during the first 2 h only. Movements were reduced during the first hour after emergence from sedation only. In summary, no EEG or behavioral evidence of sleep deprivation was observed on emergence from sedation. These results imply that sedation is associated with a restorative process reversing the natural accumulation of sleep need that occurs during wakefulness.
Prolonged sedation in the Intensive Care Unit may alter the restorative effects of naturally occurring sleep. We sedated rats during their sleep phase to determine whether sedation interferes with sleep. Upon emergence, no evidence of sleep deprivation was observed. Sedation may thus be associated with a restorative effect similar to sleep.
在重症监护病房中,使用丙泊酚可提供镇静作用且不会延长苏醒时间。然而,当持续时间较长时,持续镇静可能与自然睡眠期重叠,并可能增加睡眠剥夺的风险。我们修改了一个已建立的大鼠睡眠模型,以确定长时间的持续镇静是否会导致睡眠剥夺。大鼠在其正常睡眠阶段完全重叠的12小时内持续接受镇静。在镇静期前后收集脑电图(EEG)和运动数据。对大鼠在镇静后进行脑电图和运动方面睡眠剥夺证据的评估。与基线相比,在镇静后的前4小时内,快速眼动(REM)睡眠和非快速眼动睡眠的时间减少。非快速眼动睡眠周期的持续时间没有改变。仅在最初2小时内,非快速眼动睡眠期间的δ波段(0.5 - 4赫兹)功率降低。仅在从镇静中苏醒后的第一小时内运动减少。总之,在从镇静中苏醒时,未观察到脑电图或行为方面的睡眠剥夺证据。这些结果表明,镇静与一个恢复过程相关,该过程可逆转清醒期间自然积累的睡眠需求。
重症监护病房中的长时间镇静可能会改变自然睡眠的恢复作用。我们在大鼠睡眠阶段进行镇静,以确定镇静是否会干扰睡眠。苏醒时,未观察到睡眠剥夺的证据。因此,镇静可能与类似于睡眠的恢复作用相关。