Stimulation of the semicircular canals via the rotary chair as a means to test pharmacologic countermeasures for space motion sickness
Stimulation of the semicircular canals via the rotary chair as a means to test pharmacologic countermeasures for space motion sickness
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DOI：
10.1097/00129492-200409000-00016
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发表时间：
2004-09-01
影响因子：
2.1
通讯作者：
Blake, D
中科院分区：
文献类型：
--
作者：
Dornhoffer, J;Chelonis, TJ;Blake, D
目的：空间运动病目前的治疗经验性使用的HI抗组胺异丙嗪，但使用这种干预是有限的副作用，显着的镇静。这就造成了一个两难境地，因为在可能加剧太空运动病症状的相同条件下，充分的认知尤其重要。使用过度刺激半规管与旋转椅作为一个范例的空间运动病，我们评估了四种药物，通常用于治疗地面运动病和眩晕，其疗效在减轻模拟症状的空间运动病。研究设计：随机，前瞻性，双盲研究。设置：三级转诊中心。患者：健康的男性和女性志愿者，年龄在18岁或以上，没有神经或精神疾病史，并且没有已知的过敏或任何先前的不良反应所使用的药物。干预措施：劳拉西泮1毫克，美克洛嗪25毫克，异丙嗪25毫克，东莨菪碱0.4毫克，或安慰剂。主要结果测量：通过测量治疗前和治疗后的旋转时间以及治疗前和治疗后的症状发作时间来评估每种治疗控制与我们的空间运动病范例相关的恶心和呕吐的能力。与安慰剂相比，只有东莨菪碱对旋转持续时间的平均变化有统计学意义（p < 0.008），旋转时间增加40%以上。结论：结果显示东莨菪碱>异丙嗪>安慰剂>美克洛嗪>劳拉西泮的疗效顺序。东莨菪碱显着增加旋转时间，但没有一个治疗导致显着延迟症状的发作。
Objective: Space motion sickness is currently treated pharmacologically with the empiric use of the HI antihistamine promethazine, but use of this intervention is limited by the side effect of significant sedation. This creates a dilemma, as full cognition is particularly important during the same conditions likely to exacerbate the symptoms of space motion sickness. Using overstimulation of the semicircular canals with a rotary chair as a paradigm for space motion sickness, we evaluated four medications, commonly used for the treatment of terrestrial motion sickness and vertigo, for their efficacy in alleviating the simulated symptoms of space motion sickness.Study Design: Randomized, prospective, double-blind study.Setting: Tertiary referral center.Patients: Healthy male and female volunteers, 18 years of age or older, without history of neurologic or psychiatric disorders, and with no known allergies or any previous adverse reactions to the drugs used.Interventions: Lorazepam 1 mg, meclizine 25 mg, promethazine 25 mg, scopolamine 0.4 mg, or placebo.Main Outcome Measure: The ability of each treatment to control the nausea and vomiting associated with our paradigm for space motion sickness was evaluated by measuring time of rotation pre- and posttreatment and time of symptom onset pre- and posttreatment.Results: Only scopolamine effected a mean change in duration of rotation that reached statistical significance when compared with placebo (p < 0.008), with a greater than 40% increase in rotation time. Results with promethazine were not statistically significant.Conclusion: Results showed a rank order of efficacy of scopolamine > promethazine > placebo > meclizine > lorazepam. Scopolamine significantly increased rotation time, but none of the treatments resulted in a significant delay to onset of symptoms.