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

背景资料：动态平衡（包括重心移动）是评价静脉镇静和日间住院麻醉后街头适应性最重要的指标，研究1的目的是比较丙泊酚和咪达唑仑静脉镇静后动态平衡的恢复。镇静结束后40 min，异丙酚组动态平衡试验值明显低于咪达唑仑组。异丙酚组数字符号替代试验和握力试验在镇静结束后70 min和至少30 min均显著高于咪达唑仑组。总之，异丙酚镇静的动态平衡功能恢复快于咪达唑仑镇静。研究2的受试者是在全麻（空气-氧气-七氟醚）下接受口腔手术的患者，手术时间在2小时内。作为精确的动态平衡测试，进行了对不可预测的扰动刺激的姿势控制能力测试、有意身体倾斜测试和使用具有足部压力传感器的片材的行走分析测试。作为简单的动态平衡测试，进行了总平衡-运动功能测试，其中受试者从椅子上站起来，以最大速度行走向前和向后行走3 m，然后再次坐下。对扰动刺激的平衡控制能力、有意身体倾斜和正常速度行走的恢复时间均在全麻停止后150 min内。总平衡-运动功能恢复时间在全麻停止后210分钟内。在全麻停止后210分钟，上述功能恢复率达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.