Fothergill D M, Carlson N A
Naval Medical Research Institute, Bethesda, Maryland 20889-5607, USA.
J Appl Physiol (1985). 1996 Oct;81(4):1562-71. doi: 10.1152/jappl.1996.81.4.1562.
The influence of nitrous oxide (N2O) narcosis on the response to exercise and inspiratory resistive loading was studied in thirteen male US Navy divers. Each diver performed an incremental bicycle exercise test at 1 ATA to volitional exhaustion while breathing a 23% N2O gas mixture and a nonnarcotic gas of the same PO2, density and viscosity. The same gas mixtures were used during four subsequent 30-min steady-state submaximal exercise trials in which the subjects breathed the mixtures both with and without an inspiratory resistance (5.5 vs. 1.1 cmH2O.s.l-1 at 1 l/s). Throughout each test, subjective ratings of respiratory effort (RE), leg exertion, and narcosis were obtained with a category-ration scale. The level of narcosis was rated between slight and moderate for the N2O mixture but showed great individual variation. Perceived leg exertion and the time to exhaustion were not significantly different with the two breathing mixtures. Heart rate was unaffected by the gas mixture and inspiratory resistance at rest and during steady-state exercise but was significantly lower with the N2O mixture during incremental exercise (P < 0.05). Despite significant increases in inspiratory occlusion pressure (13%; P < 0.05), esophageal pressure (12%; P < 0.001), expired minute ventilation (4%; P < 0.01), and the work rate of N2O mixture, RE during both steady-state and incremental exercise was 25% lower with the narcotic gas than with the nonnarcotic mixture (P < 0.05). We conclude that the narcotic-mediated changes in ventilation, heart rate, and RE induced by 23% N2o are not sufficient magnitude to influence exercise tolerance at surface pressure. Furthermore, the load-compensating respiratory reflexes responsible for maintaining ventilation during resistive breathing are not depressed by N2O narcosis.
在13名美国海军男性潜水员中研究了氧化亚氮(N2O)麻醉对运动反应和吸气阻力负荷的影响。每位潜水员在1个绝对大气压下进行递增式自行车运动试验,直至自愿疲劳,期间分别呼吸含23% N2O的气体混合物以及具有相同氧分压、密度和粘度的非麻醉气体。在随后的4次30分钟稳态次最大运动试验中使用相同的气体混合物,受试者在有和没有吸气阻力(1升/秒时为5.5 vs. 1.1厘米水柱·秒·升-1)的情况下呼吸这些混合物。在每次测试过程中,使用类别评分量表获取呼吸努力(RE)、腿部用力和麻醉程度的主观评分。对于N2O混合物,麻醉程度评定为轻度至中度,但个体差异很大。两种呼吸混合物下,感觉到的腿部用力和疲劳时间没有显著差异。在静息和稳态运动期间,心率不受气体混合物和吸气阻力的影响,但在递增运动期间,N2O混合物下的心率显著更低(P < 0.05)。尽管吸气闭塞压显著升高(13%;P < 0.05)、食管压力升高(12%;P < 0.001)、每分钟呼气量增加(4%;P < 0.01)以及N2O混合物的工作率增加,但在稳态和递增运动期间,麻醉气体下的RE比非麻醉混合物低25%(P < 0.05)。我们得出结论,23% N2O引起的麻醉介导的通气、心率和RE变化幅度不足以影响表面压力下的运动耐力。此外,负责在阻力呼吸期间维持通气的负荷补偿呼吸反射不会被N2O麻醉抑制。