RESUMEN
BACKGROUND: Sedation by dexmedetomidine, like natural sleep, often causes bradycardia. We explored the nature of heart rate (HR) changes as they occur during natural sleep versus those occurring during dexmedetomidine sedation. METHODS: The present study included 30 patients who were scheduled to undergo elective surgery with spinal anesthesia. To assess HR and sedation, a pulse oximeter and bispectral index (BIS) monitor were attached to the patient in the ward and the operating room. After measuring HR and BIS at baseline, as the patients slept and once their BIS was below 70, HR and BIS were measured at 5-minute intervals during sleep. Baseline HR and BIS were also recorded before spinal anesthesia measured at 5-minute intervals after dexmedetomidine injection. RESULTS: During natural sleep, HR changes ranged from 2 to 19 beats/min (13.4 ± 4.4 beats/min), while in dexmedetomidine sedation, HR ranged from 9 to 40 beats/min (25.4 ± 8.5 beats/min). Decrease in HR was significantly correlated between natural sleep and dexmedetomidine sedation (R2 = 0.41, P < 0.001). The lowest HR was reached in 66 min during natural sleep (59 beats/min) and in 13 min with dexmedetomidine sedation (55 beats/min). The time to reach minimum HR was significantly different (P < 0.001), but there was no difference in the lowest HR obtained (P = 0.09). CONCLUSIONS: There was a correlation between the change in HR during natural sleep and dexmedetomidine sedation. The bradycardia that occurs when using dexmedetomidine may be a normal physiologic change, that can be monitored rather than corrected.
Asunto(s)
Anestesia Raquidea/métodos , Dexmedetomidina/administración & dosificación , Frecuencia Cardíaca/efectos de los fármacos , Hipnóticos y Sedantes/administración & dosificación , Sueño/efectos de los fármacos , Adulto , Anestesia Raquidea/efectos adversos , Bradicardia/inducido químicamente , Bradicardia/diagnóstico , Bradicardia/fisiopatología , Monitores de Conciencia , Dexmedetomidina/efectos adversos , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Hipnóticos y Sedantes/efectos adversos , Masculino , Persona de Mediana Edad , Sueño/fisiologíaRESUMEN
Background: Several studies have shown that dexmedetomidine (DXM), a selective α2-adrenoceptor agonist, also has neuroprotective effects. However, its effect on impaired peripheral nerve regeneration has not been studied. Materials and Methods: Forty-five Sprague-Dawley rats were randomly assigned to three groups: group 1 (control SHAM), group 2 (sciatic nerve injury + normal saline), and group 3 (sciatic nerve injury + DXM). The rats of group 3 were subdivided into the following three groups: DXM 0.5, 6, and 20 µg·kg-1 (groups 3A, 3B, and 3C, resp.). The sciatic nerve injury was assessed for nerve regeneration at 2 and 6 weeks. Results: There were no differences between groups 2 and 3 in their sciatic functional index (SFI) values or histological findings at 2 weeks postinjury. However, SFI differences were statistically significant at 6 weeks postinjury in group 3. The gross findings with H&E staining showed that the number of axons was higher in group 3 than in group 2. There was no histological difference according to the DXM concentration. Conclusion: The coincidental functional and histological assessment results of this study suggest that DXM for 6 weeks positively affects damaged peripheral nerves.
Asunto(s)
Analgésicos no Narcóticos/uso terapéutico , Dexmedetomidina/uso terapéutico , Regeneración Nerviosa/efectos de los fármacos , Neuropatía Ciática/tratamiento farmacológico , Neuropatía Ciática/fisiopatología , Animales , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Humanos , Ratas , Ratas Sprague-Dawley , Recuperación de la Función/efectos de los fármacos , Caminata/fisiologíaRESUMEN
The exposure-response relationships between subjective annoyance with sleep disturbance from railway trains and road traffic noise were established from an extensive social survey by CENVR (Center for Environmental Noise and Vibration Research) in Korea. The objectives of this research are to determine the long-term effects of noise on sleep and to compare the exposure-response relationships from different noise sources with those from other studies and to elucidate the effects of some modifying factors on subjective responses to noise. From an investigation of the percentage of a highly sleep-disturbed population (%HSD) in response to railway and road traffic noise, it was found that sleep is affected more by railway noise than by road traffic noise. The effects of non-acoustical factors on the responses were examined and sensitivity was shown to be a significant modifying factor, as it pertains to subjective sleep disturbance. A comparison of the response curves from an analysis of pooled data from predominantly European surveys by Miedema and Vos [Behav. Sleep Med. 5, 1-20 (2007)] with the response curves from this survey showed more of a subjective sleep disturbance response in this survey to railway noise, whereas there was no significant difference in terms of a response to road traffic noise.
Asunto(s)
Automóviles , Disomnias/etiología , Encuestas Epidemiológicas , Ruido del Transporte/efectos adversos , Vías Férreas , Disomnias/etnología , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Humanos , Masculino , Modelos Estadísticos , Ruido del Transporte/estadística & datos numéricos , República de Corea/epidemiologíaRESUMEN
An experimental study was performed to compare the annoyances from civil-aircraft noise, military-aircraft noise, railway noise, and road-traffic noise. Two-way within-subjects designs were applied in this research. Fifty-two subjects, who were naive listeners, were given various stimuli with varying levels through a headphone in an anechoic chamber. Regardless of the frequency weighting network, even under the same average energy level, civil-aircraft noise was the most annoying, followed by military-aircraft noise, railway noise, and road-traffic noise. In particular, penalties in the time-averaged, A-weighted sound level (TAL) of about 8, 5, and 5 dB, respectively, were found in the civil-aircraft, military-aircraft, and railway noises. The reason could be clarified through the high-frequency component and the variability in the level. When people were exposed to sounds with the same maximum A-weighted level, a railway bonus of about 3 dB was found. However, transportation noise has been evaluated by the time-averaged A-weighted level in most countries. Therefore, in the present situation, the railway bonus is not acceptable for railway vehicles with diesel-electric engines.
Asunto(s)
Percepción Auditiva , Emociones , Ruido del Transporte , Estimulación Acústica , Acústica , Adulto , Aeronaves , Algoritmos , Automóviles , Femenino , Humanos , Masculino , Ruido , Psicoacústica , Vías Férreas , Encuestas y Cuestionarios , Factores de Tiempo , Adulto JovenRESUMEN
A study of community annoyance caused by exposures to civil aircraft noise was carried out in 20 sites around Gimpo and Gimhae international airports to investigate the effect of background noise in terms of dose-effect relationships between aircraft noise levels and annoyance responses under real conditions. Aircraft noise levels were mainly measured using airport noise monitoring systems, B&K type 3597. Social surveys were administered to people living within 100 m of noise measurement sites. The question relating to the annoyance of aircraft noise was answered on an 11-point numerical scale. The randomly selected respondents, who were aged between 18 and 70 years, completed the questionnaire independently. In total, 753 respondents participated in social surveys. The result shows that annoyance responses in low background noise regions are much higher than those in high background noise regions, even though aircraft noise levels are the same. It can be concluded that the background noise level is one of the important factors on the estimation of community annoyance from aircraft noise exposure.
Asunto(s)
Aeronaves , Exposición a Riesgos Ambientales , Percepción Sonora , Ruido del Transporte/efectos adversos , Opinión Pública , Estrés Psicológico/etiología , Adolescente , Adulto , Anciano , Aeronaves/estadística & datos numéricos , Recolección de Datos , Monitoreo del Ambiente/instrumentación , Monitoreo del Ambiente/estadística & datos numéricos , Monitoreo Epidemiológico , Femenino , Vivienda , Humanos , Corea (Geográfico)/epidemiología , Masculino , Persona de Mediana Edad , Ruido/efectos adversos , Ruido del Transporte/estadística & datos numéricos , Población Rural , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Población UrbanaRESUMEN
A study of community annoyance caused by exposures to railway noise was carried out in 18 areas along railway lines to accumulate social survey data and assess the relationship between railway noise levels and annoyance responses in Korea. Railway noise levels were measured with portable sound-level meters. Social surveys were administered to people living within 50 m of noise measurement sites. A questionnaire contained demographic factors, degree of noise annoyance, interference with daily activities, and health-related symptoms. The question relating to noise annoyance was answered on an 11-point numerical scale. The randomly selected respondents, who were aged between 18 to 70 years of age, completed the questionnaire independently. In total, 726 respondents participated in social surveys. Taking into consideration the urban structure and layout of the residential areas of Korea, Japan, and Europe, one can assume that the annoyance responses caused by the railway noise in this study will be similar to those found in Japan, which are considerably more severe than those found in European countries. This study showed that one of the most important factors contributing to the difference in the annoyance responses between Korea and Europe is the distance between railways and houses.