González A G, Cortínez L I, De la Cuadra J C, Carrasco E, Rioseco A, Léniz P
Departamento de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Esp Anestesiol Reanim. 2007 Aug-Sep;54(7):414-20.
To assess the utility of propofol and succinylcholine in obtaining optimal convulsions and assuring patient safety during electroconvulsive therapy.
This was a prospective observational study of patients undergoing electroconvulsive therapy under general anesthesia with propofol and succinylcholine. We recorded patient characteristics, doses of propofol and succinylcholine, electroencephalographically-recorded duration of convulsions, and complications. Descriptive statistics were compiled and the data were subjected to analysis of correlations, comparison with the Student t test for independent samples, the Mann-Whitney U test, and analysis of variance.
We studied 108 patients, 62% women and 38% men, 80% classified as ASA 1 and 20% as ASA 2. The patients underwent 844 sessions of electroconvulsive therapy; their mean (SD) age was 39.95 (18.09) years. The doses of propofol and succinylcholine were 1.34 (0.32) mgxkg(-1) and 1.35 (0.26) mgxkg(-1), respectively. The mean recorded duration of the first convulsion (29.87 [22.42] seconds) was negatively correlated with age (r = -0.12) and unrelated to propofol dose (r = 0.06) or body weight (r = 0.02). Male and schizophrenic patients had longer-lasting convulsions (P < .01). Cardiovascular complications occurred in 2.4% and psychomotor agitation in 1.4%; there were no respiratory complications, musculoskeletal injuries, nausea, or vomiting.
Electroconvulsive therapy can be safely applied in an operating room or similar space undergeneral anesthesia and with a neuromuscular blockade in order to prevent psychological or musculoskeletal trauma. Propofol did not affect the convulsions at the dosages administered.
评估丙泊酚和琥珀酰胆碱在电休克治疗中获得最佳惊厥效果及确保患者安全方面的效用。
这是一项对在丙泊酚和琥珀酰胆碱全身麻醉下接受电休克治疗的患者进行的前瞻性观察研究。我们记录了患者特征、丙泊酚和琥珀酰胆碱的剂量、脑电图记录的惊厥持续时间以及并发症。编制了描述性统计数据，并对数据进行相关性分析、独立样本的学生t检验、曼 - 惠特尼U检验和方差分析。
我们研究了108例患者，其中62%为女性，38%为男性，80%分类为美国麻醉医师协会（ASA）1级，20%为ASA 2级。患者接受了844次电休克治疗；他们的平均（标准差）年龄为39.95（18.09）岁。丙泊酚和琥珀酰胆碱的剂量分别为1.34（0.32）mg·kg⁻¹和1.35（0.26）mg·kg⁻¹。首次惊厥的平均记录持续时间（29.87 [22.42]秒）与年龄呈负相关（r = -0.12），与丙泊酚剂量（r = 0.06）或体重（r = 0.02）无关。男性和精神分裂症患者的惊厥持续时间更长（P <.01）。心血管并发症发生率为2.4%，精神运动性激越发生率为1.4%；未发生呼吸并发症、肌肉骨骼损伤、恶心或呕吐。
电休克治疗可在手术室或类似空间在全身麻醉和神经肌肉阻滞下安全应用，以防止心理或肌肉骨骼创伤。所给药剂量的丙泊酚不影响惊厥。
