Walder B, Seeck M, Tramèr M R
Division of Surgical Intensive Care Unit, University Hospitals of Geneva, Switzerland.
J Neurosurg Anesthesiol. 2001 Apr;13(2):93-8. doi: 10.1097/00008506-200104000-00005.
A systematic search (Medline, Cochrane library, Embase, bibliographies, to 5.2000, no language restriction) was performed for published reports of randomized comparisons of propofol and methohexital for anesthesia during electroconvulsive therapy. We analyzed 15 trials with data on 706 patients. The duration of motor seizure was shorter with propofol (range, 18-39 seconds) than with methohexital (range, 26-48 seconds, weighted mean difference 8.4 seconds [95% CI, 6.6-10.0]). With both propofol and methohexital, there was little evidence of an association between dose and duration of motor seizure (for propofol: r2 = 0.25, P = .08; for methohexital: r2 = 0.11, P = .27). Two small trials investigated clinical outcome; results were inconclusive. Data on adverse effects were sparse. Duration of seizure was not proven to be a useful measure of treatment success in the study of electroconvulsive therapy with propofol or methohexital. The impact of the technique of anesthesia on the underlying disease needs to be established.
我们进行了一项系统检索（检索了Medline、Cochrane图书馆、Embase以及参考文献，截至2000年5月，无语言限制），以查找关于丙泊酚和甲己炔巴比妥在电休克治疗期间用于麻醉的随机对照比较的已发表报告。我们分析了15项试验，涉及706例患者的数据。丙泊酚组的运动性癫痫持续时间较短（范围为18 - 39秒），短于甲己炔巴比妥组（范围为26 - 48秒，加权平均差为8.4秒[95%可信区间，6.6 - 10.0]）。对于丙泊酚和甲己炔巴比妥，几乎没有证据表明剂量与运动性癫痫持续时间之间存在关联（丙泊酚：r2 = 0.25，P = 0.08；甲己炔巴比妥：r2 = 0.11，P = 0.27）。两项小型试验研究了临床结局，结果尚无定论。关于不良反应的数据较少。在丙泊酚或甲己炔巴比妥用于电休克治疗的研究中，癫痫持续时间未被证明是治疗成功的有效衡量指标。麻醉技术对基础疾病的影响有待确定。
