A Study on Recovery of Dynamic Balance from Intravenous Sedation and Day Stay Anesthesia

背景：在静脉镇静和日间麻醉后，动态平衡（包括重心移动）是评估街头健康的最重要指标。研究1的目的是比较异丙酚和咪达唑仑静脉镇静后动态平衡的恢复情况。镇静结束后40 min，异丙酚组计算机动态体位测量动态平衡值明显低于咪达唑仑组。在镇静结束后70 min和至少30 min，异丙酚组的手指符号替代测试和握力测试值分别显著高于咪达唑仑组。综上所述，异丙酚镇静组动态平衡功能的恢复比咪达唑仑镇静组更快。这一结果可能与精神运动功能和肌力恢复过程的差异有关。研究2为拟行口腔手术的患者，手术时间在2小时以内，全身麻醉（空气-氧-七氟醚）。进行了精确动平衡测试、不可预测扰动刺激下的体位控制能力测试、有意身体倾斜测试和带足压传感器的平板行走分析测试。作为简单的动平衡测试，总平衡-运动功能测试，受试者从椅子上站起来，以最大速度向前和向后行走3 m，然后再次坐下。对摄动刺激的平衡控制能力、有意识的身体倾斜、正常速度行走的恢复时间均在全麻停止后150分钟内。总平衡-运动功能恢复时间在全麻停止后210分钟内。停用全身麻醉后210分钟，上述能力恢复率达80%左右。

Background : Dynamic balance involving movement of the center of gravity is most important for the evaluation of street fitness after intravenous sedation and day stay anesthesia.The purpose of study 1 was to compare the recovery of dynamic balance after intravenous sedation with propofol arid midazolam. The values of dynamic balance test in computerized dynamic posturography were significantly lower in propofol group than in midazolam group 40 min after the end of sedation. The values of digit symbol substitution test and grip strength test were significantly greater in propofol group than in midazolam group 70 min and at least 30 min after the end of sedation, respectively. In summary, recovery of dynamic balance function in propofol sedation was more rapid than that in midazolam sedation. This result may derive from the difference in the recovery process of psychomotor function and muscle strength.In study 2,the subjects were patients to be undergone oral surgery in which surgical time was within 2 hours with general anesthesia (air-oxygen-sevoflurane). As precise dynamic balance tests, postural control ability test against unpredictable perturbation stimuli, intentional body leaning test, and walking analyzing test using sheet with foot pressure sensor were performed. As simple dynamic balance test, total balance-motor function test in which subjects stand up from a chair, walk 3 m forward and back with maximum speed walking, and sit down again were performed. The recovery times of ability of balance control against perturbation stimuli, intentional body leaning, and normal speed walking were all within 150 minutes after cessation of general anesthesia. The recovery time of total balance-motor function was within 210 minutes after cessation of general anesthesia. The rate of the patients who recovered above abilities reached up to about 80% 210 minutes after cessation of general anesthesia.