Krystal Andrew D, Weiner Richard D, Dean Margaret D, Lindahl Virginia H, Tramontozzi Louis A, Falcone Grace, Coffey C Edward
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
J Neuropsychiatry Clin Neurosci. 2003 Winter;15(1):27-34. doi: 10.1176/jnp.15.1.27.
The authors retrospectively compared the seizure duration, ictal EEG, and cognitive side effects of ketamine and methohexital anesthesia with ECT. This comparison was carried out with data from consecutive index ECT treatments that occurred immediately before and after a switch from methohexital to ketamine in 36 patients. Ketamine was well tolerated and prolonged seizure duration overall, but particularly in those who had a seizure duration shorter than 25 seconds with methohexital at the maximum available stimulus intensity. Ketamine also increased midictal EEG slow-wave amplitude. Thus, a switch to ketamine may be useful when it is difficult to elicit a robust seizure. Faster post-treatment reorientation with ketamine may suggest a lower level of associated cognitive side effects.
作者回顾性比较了氯胺酮和甲己炔巴比妥麻醉联合电休克治疗（ECT）的癫痫发作持续时间、发作期脑电图及认知副作用。该比较采用了36例患者从甲己炔巴比妥转换为氯胺酮前后立即进行的连续索引ECT治疗数据。氯胺酮耐受性良好，总体上延长了癫痫发作持续时间，尤其是在最大可用刺激强度下使用甲己炔巴比妥时癫痫发作持续时间短于25秒的患者中。氯胺酮还增加了发作期脑电图慢波振幅。因此，在难以引发强烈癫痫发作时，改用氯胺酮可能有用。氯胺酮治疗后更快的重新定向可能表明相关认知副作用水平较低。
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