Kovac A L, Goto H, Pardo M P, Arakawa K
Department of Anesthesiology, University of Kansas Medical Center, Kansas City 66103.
Can J Anaesth. 1991 Mar;38(2):204-9. doi: 10.1007/BF03008146.
Twelve ASA physical status I-III patients were enrolled in a double-blind, prospective, randomized, three-way, within-patient crossover study designed to determine the effect of two standard esmolol bolus doses (100 and 200 mg) on the haemodynamic response and seizure duration during electro-convulsive therapy (ECT). Esmolol or placebo was administered one minute prior to induction of anaesthesia and exactly two minutes before ECT. Both the 100 and 200 mg bolus doses significantly blunted the maximum increase in heart rate (HR) and mean arterial pressure (MAP) following ECT in comparison with placebo. Compared with placebo, esmolol 100 mg decreased maximum HR by 23 +/- 3%, maximum MAP by 17 +/- 7% and maximum rate-pressure product (RPP) by 40 +/- 9%. Esmolol 200 mg decreased maximum HR by 25 +/- 3%, maximum MAP by 19 +/- 3% and maximum RPP by 42 +/- 5%. No significant difference was found between the two esmolol doses at corresponding measurement points before and after ECT. Treatment with esmolol 200 mg resulted in a significantly shorter mean seizure duration than with placebo. As the 200 mg dose caused a shorter seizure duration and the haemodynamic effects of 100 mg and 200 mg doses were similar, it was concluded that the 100 mg esmolol bolus dose was the better dose for ECT.
十二名美国麻醉医师协会（ASA）身体状况为I - III级的患者参与了一项双盲、前瞻性、随机、三因素、患者自身交叉研究，该研究旨在确定两种标准剂量的艾司洛尔推注量（100毫克和200毫克）对电休克治疗（ECT）期间血流动力学反应和癫痫发作持续时间的影响。在诱导麻醉前1分钟且恰好在ECT前2分钟给予艾司洛尔或安慰剂。与安慰剂相比，100毫克和200毫克推注剂量均显著减弱了ECT后心率（HR）和平均动脉压（MAP）的最大增幅。与安慰剂相比，100毫克艾司洛尔使最大HR降低了23±3%，最大MAP降低了17±7%，最大速率 - 压力乘积（RPP）降低了40±9%。200毫克艾司洛尔使最大HR降低了25±3%，最大MAP降低了19±3%，最大RPP降低了42±5%。在ECT前后的相应测量点，两种艾司洛尔剂量之间未发现显著差异。200毫克艾司洛尔治疗导致的平均癫痫发作持续时间明显短于安慰剂。由于200毫克剂量导致癫痫发作持续时间更短，且100毫克和200毫克剂量的血流动力学效应相似，因此得出结论，100毫克艾司洛尔推注剂量对ECT而言是更佳剂量。
