Department of Anaesthesia and Pain Management, Royal North Shore Hospital, St Leonards NSW, Australia.
J Affect Disord. 2010 Oct;126(1-2):330-3. doi: 10.1016/j.jad.2010.02.134. Epub 2010 Mar 21.
The addition of small amounts of lignocaine (50 mg) to propofol (200 mg) has been previously shown to reduce pain in injection, a common problem with this particular anaesthetic agent. The aim of this study was to investigate whether using the mixture of propofol plus lignocaine had any adverse effects on ECT seizure expression (duration, and ictal quality).
Ictal EEG records were retrospectively examined in 29 patients who underwent 80 pairs of ECT treatments, one given with propofol alone and one with propofol plus lignocaine. Ictal quality was manually rated for the transition from the polyspike phase to the slow wave phase, amplitude of the mid-ictal spike-and-wave phase, regularity of morphology of the predominant pattern of the slow wave phase, stereotypy, variability of the morphology and amplitude of the slow wave phase and post-ictal suppression.
There was no significant difference in seizure duration between the two groups (33.4+/-13.0 s (propofol) vs. 33.6+/-11.2 s (propofol plus lignocaine). Furthermore although the addition of lignocaine delayed the onset of the slow wave phase by about 1s, it resulted in an improvement in three of four of the other measures of ictal quality.
The addition of a small dose of lignocaine to propofol during ECT treatment enhanced rather than reduced the quality of the seizures produced.
先前的研究表明，在丙泊酚（200mg）中加入少量的利多卡因（50mg）可减轻该特定麻醉剂注射时的疼痛，这是一个常见问题。本研究旨在探讨丙泊酚加利多卡因混合使用是否对电惊厥治疗（ECT）的发作表现（发作持续时间和发作质量）有任何不良影响。
回顾性检查了 29 名接受 80 对 ECT 治疗的患者的发作期脑电图记录，其中 1 组仅给予丙泊酚，另 1 组给予丙泊酚加利多卡因。手动评估发作质量，评估指标包括从多棘波期到慢波期的转变、中棘波-慢波期的振幅、慢波期主要形态的形态规则性、刻板性、慢波期形态和振幅的可变性以及发作后抑制。
两组的发作持续时间无显著差异（丙泊酚组 33.4+/-13.0 s，丙泊酚加利多卡因组 33.6+/-11.2 s）。此外，虽然利多卡因的加入使慢波期的起始延迟了约 1s，但它导致了发作质量的四个评估指标中的三个得到了改善。
在 ECT 治疗中，向丙泊酚中加入小剂量的利多卡因可以增强而不是降低所产生的发作质量。
