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脊髓麻醉对静息代谢率和股四头肌肌机械图的影响。

Effects of spinal anesthesia on resting metabolic rate and quadriceps mechanomyography.

作者信息

McKay William Paul, Lett Brendan, Chilibeck Philip D, Daku Brian L

机构信息

Department of Anesthesia, University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

Eur J Appl Physiol. 2009 Jul;106(4):583-8. doi: 10.1007/s00421-009-1054-1. Epub 2009 Apr 9.

Abstract

Previous work by our group has shown by mechanomyography (MMG) that resting muscle is mechanically active. Ten patients having spinal anesthesia for surgery, which paralyses muscle below the waist, were studied to help determine whether resting-muscle mechanical activity plays a significant role in resting metabolism, and to further determine if the phenomenon is neurally mediated. Resting metabolic rate (RMR) by indirect calorimetry, and mid-anterior thigh MMG by accelerometer, were recorded before and during spinal anesthesia. Spinal anesthesia produced a 25% decrease in oxygen uptake (mean +/- standard deviation: pre-spinal 228 +/- 76; during spinal 171 +/- 67 ml min(-1); P < 0.001) and 37% decrease in mean absolute MMG signal amplitude (pre-spinal-anesthetic 10.6 +/- 3.9; during spinal: 6.7 +/- 3.5 mm s(-2); P < 0.001). Decreased oxygen uptake in individuals correlated with decreased resting-muscle mechanical activity (R = 0.624; P = 0.05). Paralysis of muscle below the waist reduced RMR and resting-muscle mechanical activity.

摘要

我们团队之前的研究通过肌动图(MMG)表明,静息肌肉具有机械活性。对10名接受手术脊髓麻醉(该麻醉使腰部以下肌肉麻痹)的患者进行了研究,以帮助确定静息肌肉的机械活动是否在静息代谢中起重要作用,并进一步确定该现象是否由神经介导。在脊髓麻醉前和麻醉期间,通过间接量热法记录静息代谢率(RMR),并通过加速度计记录大腿前中部的MMG。脊髓麻醉使氧气摄取量降低了25%(平均值±标准差:脊髓麻醉前228±76;脊髓麻醉期间171±67 ml·min⁻¹;P<0.001),平均绝对MMG信号幅度降低了37%(脊髓麻醉前10.6±3.9;脊髓麻醉期间:6.7±3.5 mm·s⁻²;P<0.001)。个体氧气摄取量的降低与静息肌肉机械活动的降低相关(R=0.624;P=0.05)。腰部以下肌肉麻痹降低了RMR和静息肌肉机械活动。

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