Lafère P, Balestra C, Hemelryck W, Guerrero F, Germonpré P
Anaesthesia & Reanimation, Hopital de la Cavale-Blanche, Brest, France.
Environmental & Occupational Physiology, Haute Ecole Paul Henri Spaak, Auderghem, Belgium.
Int J Sports Med. 2016 Dec;37(14):1124-1128. doi: 10.1055/s-0042-110573. Epub 2016 Oct 13.
Although many factors contributing to inert gas narcosis onset and severity have been put forward, the available evidence is not particularly strong. Using objective criteria, we have assessed brain impairment associated with narcosis under various environmental diving conditions. 40 volunteers performed a no-decompression dive (33 m for 20 min) either in a dry chamber, a pool or open sea. They were assessed by critical flicker fusion frequency before the dive, upon arriving at depth, 5 min before ascent, on surfacing and 30 min post-dive. Compared to the pre-dive value, the mean value of each measurement was significantly different. An increase of flicker fusion to 105.00±0.69% when arriving at depth is followed by a decrease to 94.05±0.65%. This impairment persists when surfacing and 30 min post-dive, decreasing further to 96.36±0.73% and 96.24±0.73%, respectively. Intragroup comparison failed to demonstrate any statistical difference. When objectively measured narcosis may not be influenced by external factors other than pressure and gas. This might be of importance for training to avoid any over- or underestimation of the severity of narcosis based only on subjective symptoms.
尽管已经提出了许多导致惰性气体麻醉发作和严重程度的因素，但现有证据并不特别充分。我们使用客观标准，评估了在各种环境潜水条件下与麻醉相关的脑损伤。40名志愿者在干燥舱、水池或公海进行了一次免减压潜水（33米，20分钟）。在潜水前、到达深度时、上升前5分钟、浮出水面时以及潜水后30分钟，通过临界闪烁融合频率对他们进行评估。与潜水前的值相比，每次测量的平均值均有显著差异。到达深度时闪烁融合增加到105.00±0.69%，随后下降到94.05±0.65%。这种损伤在浮出水面和潜水后30分钟时仍然存在，分别进一步下降到96.36±0.73%和96.24±0.73%。组内比较未显示出任何统计学差异。当进行客观测量时，麻醉可能不受压力和气体以外的外部因素影响。这对于培训避免仅基于主观症状对麻醉严重程度进行任何高估或低估可能具有重要意义。
