Valentino Daniel J, Walter Robert J, Dennis Andrew J, Nagy Kimberly, Loor Michele M, Winners Jerry, Bokhari Faran, Wiley Dorion, Merchant Azher, Joseph Kimberly, Roberts Roxanne
Cook Country Trauma Unit, Chicago, Illinois, USA.
J Surg Res. 2007 Nov;143(1):78-87. doi: 10.1016/j.jss.2007.03.049.
Stun guns or electromuscular incapacitation devices (EMIs) generate between 25,000 and 250,000 V and can be discharged continuously for as long as 5 to 10 min. In the United States, over 200,000 individuals have been exposed to discharges from the most common type of device used. EMI devices are being used increasingly despite a lack of objective laboratory data describing the physiological effects and safety of these devices. An increasing amount of morbidity, and even death, is associated with EMI device use. To examine this type of electrical injury, we hypothesized that EMI discharges will induce acute or delayed cardiac arrhythmia and neuromuscular injury in an animal model.
Using an IACUC approved protocol, from May 2005 through June 2006 in a teaching hospital research setting, 30 Yucatan mini-pigs (24 experimentals and 6 sham controls) were deeply anesthetized with ketamine and xylazine without paralytics. Experimentals were exposed to discharges from an EID (MK63; Aegis Industries, Bellevue, ID) over the femoral nerve on the anterior left hind limb for an 80 s exposure delivered as two 40 s discharges. EKGs, EMGs, troponin I, CK-MB, potassium, and myoglobin levels were obtained pre-discharge and post-discharge at 5, 15, 30, and 60 min, 24, 48, and 72 h (n = 6 animals) and 5, 15, and 30 d post-discharge (n = 6 animals at each time point). Skin, skeletal muscle, and peripheral nerve biopsies were studied bilaterally. Data were compared using one-way analysis of variance and paired t-tests. P-values <0.05 were considered significant.
No cardiac arrhythmias or sudden deaths were seen in any animals at any time point. No evidence of skeletal muscle damage was detected. No significant changes were seen in troponin I, myoglobin, CK-MB, potassium, or creatinine levels. There were no significant changes in compound muscle action potentials (CMAP). No evidence of conduction block, conduction slowing, or axonal loss were detected on EMG. M-wave latency (M(lat), ms), amplitude (M(amp), mV), area (M(area), mV-ms), and duration (M(dur), ms) were not significantly affected by MK63 discharge compared with contralateral or sham controls. F-wave latency (F(lat), ms), a sensitive indicator of retrograde nerve conduction and function, was not significantly affected by MK63 discharge compared with contralateral or sham controls. No significant histological changes were seen at any time point in skeletal muscle or peripheral nerve biopsies although mild skin inflammation was evident.
There was no evidence of acute arrhythmia from MK63 discharges. No clinically significant changes were seen in any of the physiological parameters measured here at any time point. Neuromuscular function was not significantly altered by the MK63 discharge. In this animal model, even lengthy MK63 discharges did not induce muscle or nerve injury as seen using EMG, blood chemistry, or histology.
电击枪或肌肉麻痹装置(EMI)可产生25000至250000伏的电压,并且能够持续放电长达5至10分钟。在美国,超过20万人遭受过最常用类型装置的电击。尽管缺乏描述这些装置生理效应和安全性的客观实验室数据,但EMI装置的使用却越来越多。与EMI装置使用相关的发病率甚至死亡率都在上升。为了研究这类电损伤,我们假设EMI放电会在动物模型中诱发急性或延迟性心律失常以及神经肌肉损伤。
采用经机构动物护理和使用委员会(IACUC)批准的方案,于2005年5月至2006年6月在一家教学医院的研究环境中,用氯胺酮和赛拉嗪对30只尤卡坦小型猪(24只实验猪和6只假手术对照猪)进行深度麻醉,未使用麻痹剂。实验猪的左后肢前侧股神经接受电子 incapacitation device(EID,MK63;宙斯盾工业公司,爱达荷州贝尔维尤)的80秒电击,分两次40秒放电。在放电前以及放电后5、15、30和60分钟、24、48和72小时(n = 6只动物)以及放电后5、15和30天(每个时间点n = 6只动物)获取心电图、肌电图、肌钙蛋白I、肌酸激酶同工酶(CK-MB)、钾和肌红蛋白水平。对双侧的皮肤、骨骼肌和周围神经进行活检。数据采用单因素方差分析和配对t检验进行比较。P值<0.05被认为具有统计学意义。
在任何时间点,任何动物均未出现心律失常或猝死。未检测到骨骼肌损伤的证据。肌钙蛋白I、肌红蛋白、CK-MB、钾或肌酐水平未见显著变化。复合肌肉动作电位(CMAP)无显著变化。肌电图未检测到传导阻滞、传导减慢或轴突损失的证据。与对侧或假手术对照相比,MK63放电对M波潜伏期(M(lat),毫秒)、振幅(M(amp),毫伏)、面积(M(area),毫伏-毫秒)和持续时间(M(dur),毫秒)无显著影响。F波潜伏期(F(lat),毫秒)是逆行神经传导和功能的敏感指标,与对侧或假手术对照相比,MK63放电对其无显著影响。尽管有轻度皮肤炎症,但在任何时间点的骨骼肌或周围神经活检中均未见显著组织学变化。
没有证据表明MK63放电会导致急性心律失常。在任何时间点,这里测量的任何生理参数均未出现具有临床意义的变化。MK63放电未显著改变神经肌肉功能。在这个动物模型中,即使是长时间暴露于MK63放电,也未如通过肌电图、血液化学或组织学所见那样诱发肌肉或神经损伤。