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In recent years, studies have shown that general anesthesia would affect patients' sleep rhythm to certain extent, which contribute to postoperative sleep disorders. Long-term dysfunction of sleep rhythm will seriously affect patients' outcome and recovery. Therefore, how general anesthesia affects sleep rhythm has become one of the hot topic of clinical. This paper will illustrate the effect of different general anesthetics and anesthetics methods on sleep rhythm and the effect of sleep disorders on postoperative delirium, cardiovascular events and immune function.
ABSTRACT
Introducción: la Estimulación Magnética Transcraneal (EMT) es una técnica neurofsiológica, que permite la inducción de una corriente en el cerebro de forma segura y no invasiva. Está basada en los principios de inducción electromagnética descubiertos por el investigador Michael Faraday hace dos siglos. Recién en 1984, Anthony Barker y su equipo de trabajo desarrollaron un estimulador que permitía despolarizar neuronas en la corteza motora y provocar movimientos contralaterales al activar vías corticoespinales, a partir de lo cual se ha logrado su aplicación en clínica psiquiátrica para diferentes trastornos. La EMTr puede utilizarse como complemento de otros métodos neurocientífcos en el estudio de vías motoras centrales, para el estudio de la excitabilidad cortical y en el mapeo de funciones cerebrales corticales, pudiendo combinar la capacidad de resolución temporal y espacial y la potencialidad de activar o interferir en funciones cerebrales. Materiales y métodos: los pacientes fueron seleccionados de acuerdo al diagnóstico bajo la patología F 33 F 51 por el personal del servicio y remitidos a la unidad de Estimulación Magnética Transcraneal. Se les realizó exámenes complementarios como: TAC de cráneo, electroencefalograma, valoración psicológica pre y post EMTr, dentro de un protocolo estrictamente aplicado, sin el cual no se decide proceder a este tratamiento. Resultados: en el presente estudio no se hizo diferenciaciones entre el tipo de depresión y tampoco en lo relacionado a los trastornos del ritmo del sueño. Se encontró satisfacción en la mayoría de pacientes, sometidos a este tratamiento y muchos mejoraron su depresión y calidad de sueño con la estimulación repetitiva, proponiéndose como una nueva opción de tratamiento no farmacológico ni psicoterapéutico; además es accesible a todo tipo de población, siempre y cuando se cuenta con la infraestructura tecnológica para este procedimiento.
ABSTRACT Introduction: transcranial magnetic stimulation (TMS) is a neurophysiological technique that allows electric currents induction into the brain in a safe and noninvasive way. TMS is based on electromagnetic induction discovered by Faraday two centuries ago. Only in 1984, Anthony Barker and his team developed a stimulator that allowed depolarization of neurons in the motor cortex causing contralateral movements by activating corticospinal pathways, from which it has achieved its application on different conditions in psychiatric clinic. TMS can be used with other neuroscientifc methods to combine the ability of temporal and spatial resolution and the potentiality to activate or interfere brain functions when studying central motor pathways, cortical excitability and brain cortical function mapping. Materials and methods: for the study, patients were selected under pathology F33 and F51, diagnosed by medical service personnel and sent to the Magnetic Stimulation Unit. Additional tests such as head CT, EEG, psychological evaluation pre and post rTMS (repetitive TMS) were performed within a strict protocol. If some of the tests could not be carried out, the treatment did not proceed. Results: in this study, differences on type of depression or sleep rhythm disorders were not made. Our results showed that satisfaction was found in the majority of patients undergoing this treatment and many of them even improved with repetitive stimulation their depression and sleep quality, thus, proposing an alternate non-pharmacological or psychotherapeutic treatment. Besides, it is accessible to most people, as long as the technological infrastructure for this procedure is set up.
Subject(s)
Humans , Male , Female , Middle Aged , Sleep Wake Disorders , Cerebral Cortex , Depression , Efferent Pathways , Transcranial Magnetic Stimulation , Motor Cortex , Psychiatry , Brain Mapping , Cortical ExcitabilityABSTRACT
ObjectiveTo discuss the impact of conflict psychological stress on rats'sleep time and sleep phrase.Methods20 Wistar male rats were randomly divided into vehicle group and model group,10 in each group.The improved experiment of Vogel drinking water conflict was used to establish the model of conflict psychological stress in rats and monitoring the changes of rats'weight and concentration of corticosterone (CORT) in serum after a week.After one week,the 12 h EEG and EMG of rats were traced by the polygraph in order to clarify the effect of conflict psychological stress on rats′ sleep time and sleep phrase.ResultsAfter one week,compared with vehicle group the weight of model group decreased significantly ( t =2.87,P ＜ 0.05 ),the concentration of CORT in serum raised significantly( t=5.19,P ＜ 0.05 ).A week later,compared the vehicle group,total sleep time( TST),light sleep,slow wave sleep(SWS) and rapid eye movement sleep (REM) time in model group rats ( (337.8 ±84.2)min,( 169 ±49.2) min,( 136.9 ±40.8)min,(33.1 ± 10.1 ) min for vehicle group; ( 155.4 ±16.7 ) min,( 111.6 ± 16.4 ) min,( 30.6 ± 4.9 ) min,( 12.6 ± 3.3 ) min for model group) were significantly reduced ( t =6.75,2.43,5.51,5.78,P ＜ 0.05 ),and the proportion of lightsleep increased ( (49.6 ± 3.4 ) ％,( 71.7 ±5.4)％ ) ( t =6.90,P＜0.05),the proportion of SWS decreased( (40.3 ± 10.9)％,( 19.8 ±3.2)％ ) ( t=6.74,P ＜ 0.05 ) ;but no significant change in the proportion of REM ( t =1.57,P＞ 0.05 ).Rats,sleep-wake rhythm figure indicated that the rats'sleep duration reduced and the number of awakening increased ; sleep tended to be fragmentation.ConclusionsConflict psychological stress lead to hypothalamus-pituitary-adrenal axis hyperactivity,weight loss,and the rhythm of sleep and sleep phase change in rats.