Wajima Z, Yoshikawa T, Ogura A, Shiga T, Inoue T, Ogawa R
Department of Anaesthesia, Chiba Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inbu-mura, Inba-gun, Chiba 270-1694, Japan.
Anaesth Intensive Care. 2002 Dec;30(6):742-6. doi: 10.1177/0310057X0203000604.
Electroconvulsive therapy (ECT) is commonly associated with acute hyperdynamic cardiovascular responses, and we hypothesize that intravenous lignocaine can blunt this response. We have measured the effect of lignocaine 1.5 mg/kg i.v. on heart rate and mean arterial pressure during electroconvulsive therapy. Furthermore, we also assessed seizure duration using both the cuff method and two-lead electroencephalography. We studied 25 patients using a randomized, double-blind, placebo-controlled crossover study design. Patients in the control group were given intravenous saline 0.075 ml/kg, and those in the lignocaine group were given intravenous lignocaine 2% 1.5 mg/kg, and this treatment was conducted one minute before intravenous propofol 1.5 mg/kg to induce unconsciousness. Succinylcholine 1.5 mg/kg was then administered intravenously and electrical stimulation was administered after fasciculation. Measurements were taken at the baseline, prior to succinycholine, prior to electroconvulsive therapy and at the peak response after electroconvulsive therapy. Intravenous lignocaine significantly reduced the increases in heart rate after electroconvulsive therapy, as compared with the placebo. The use of intravenous lignocaine was, however, associated with a remarkably shortened seizure duration. Due to the reduction in seizure duration, routine administration of intravenous lignocaine may not be advisable since it may interfere with the psychotherapeutic efficacy of electroconvulsive therapy. However, intravenous lignocaine medication for electroconvulsive therapy is potentially useful for reducing tachycardia in high-risk patients and reducing the severity of propofol injection pain in comparison with a placebo.
电休克疗法（ECT）通常与急性高动力性心血管反应相关，我们推测静脉注射利多卡因可减轻这种反应。我们测量了静脉注射1.5mg/kg利多卡因对电休克治疗期间心率和平均动脉压的影响。此外，我们还使用袖带法和双导联脑电图评估了癫痫发作持续时间。我们采用随机、双盲、安慰剂对照交叉研究设计对25例患者进行了研究。对照组患者静脉注射0.075ml/kg生理盐水，利多卡因组患者静脉注射2%利多卡因1.5mg/kg，该治疗在静脉注射1.5mg/kg丙泊酚诱导昏迷前1分钟进行。然后静脉注射1.5mg/kg琥珀酰胆碱，在出现肌束颤动后给予电刺激。在基线、琥珀酰胆碱给药前、电休克治疗前以及电休克治疗后的峰值反应时进行测量。与安慰剂相比，静脉注射利多卡因显著降低了电休克治疗后心率的升高。然而，静脉注射利多卡因与癫痫发作持续时间显著缩短有关。由于癫痫发作持续时间缩短，常规静脉注射利多卡因可能不可取，因为它可能会干扰电休克治疗的心理治疗效果。然而，与安慰剂相比，用于电休克治疗的静脉注射利多卡因药物在降低高危患者心动过速以及减轻丙泊酚注射疼痛的严重程度方面可能是有用的。
