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[麻醉剂对人体正中神经刺激体感诱发电位的影响——志愿者单次给药后的分析]

[Effects of anesthetics on somatosensory evoked potentials by median nerve stimulation in human--analyses after single administration in volunteers].

作者信息

Murata Y

机构信息

Department of Anesthesiology, Kanagawa Dental College, Yokosuka.

出版信息

Masui. 1998 Aug;47(8):944-54.

PMID:9753959
Abstract

In the present study, effects of midazolam, thiopental sodium, propofol, and nitrous oxide upon SEP in a clinically used dose were investigated on 24 male volunteers. In addition, antagonistic actions of flumazenil and naloxone against effects of midazolam and nitrous oxide, respectively, on SEP were studied. Midazolam had no effect on latencies of N 20 and P 25, but increased latency of P 45 and attenuated P 100 amplitude. Flumazenil reversed these effects of midazolam of P 45 latency and P 100 amplitude to their control values. While thiopental sodium and propofol suppressed P 100 amplitude, they had no effect on N 20, P 25, P 45 latencies. Nitrous oxide elongated latencies of N 20, P 25, P 45 and decreased P 100 amplitude. Naloxone reversed the effects of nitrous oxide on N 20 and P 25 latencies without affecting increased P 45 latency and attenuated P 100 amplitude. These results suggest that midazolam might have an analgesic action of suppressing cortical sensory neurons, whereas thiopental sodium and propofol have no effect on neurons in the primary sensory cortex. The finding that naloxone antagonized the increased latencies of N 20 and P 25 by nitrous oxide could be explained by the analgesic action of nitrous oxide that could be mediated by opioid receptors. The results also indicate that electrical activities of the cortical neurons in the associated area are more susceptible to psychotropic agents than those in the primary sensory cortex. The effects of anesthetics on SEP appear to reflect their characteristics of functioning mechanisms on cortical neurons. Analysis of SEP is, therefore, useful for the assessment of the mechanism and the acting site of anesthetics in the sensory cortex.

摘要

在本研究中,对24名男性志愿者研究了临床常用剂量的咪达唑仑、硫喷妥钠、丙泊酚和氧化亚氮对体感诱发电位(SEP)的影响。此外,还研究了氟马西尼和纳洛酮分别对咪达唑仑和氧化亚氮所致SEP影响的拮抗作用。咪达唑仑对N20和P25的潜伏期无影响,但增加了P45的潜伏期并减弱了P100的波幅。氟马西尼使咪达唑仑对P45潜伏期和P100波幅的这些影响恢复到对照值。硫喷妥钠和丙泊酚抑制P100波幅,但对N20、P25、P45潜伏期无影响。氧化亚氮延长N20、P25、P45的潜伏期并降低P100波幅。纳洛酮逆转了氧化亚氮对N20和P25潜伏期的影响,但不影响P45潜伏期的延长和P100波幅的减弱。这些结果表明,咪达唑仑可能具有抑制皮质感觉神经元的镇痛作用,而硫喷妥钠和丙泊酚对初级感觉皮质的神经元无影响。纳洛酮拮抗氧化亚氮所致N20和P25潜伏期延长这一发现,可用氧化亚氮可能由阿片受体介导的镇痛作用来解释。结果还表明,相关区域皮质神经元的电活动比初级感觉皮质的神经元对精神药物更敏感。麻醉药对SEP的影响似乎反映了它们在皮质神经元上的作用机制特点。因此,SEP分析有助于评估麻醉药在感觉皮质的作用机制和作用部位。

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