Department of Anesthesia, Stanford University, 300 Pasteur Dr, Stanford, CA 94305-5117, USA.
J ECT. 2013 Sep;29(3):189-95. doi: 10.1097/YCT.0b013e3182887b5b.
Postictal agitation (PIA) after electroconvulsive therapy (ECT) is a major medical problem. This observational study investigated the incidence and severity of PIA and evaluated propofol as a treatment option in a patient population.
The study included 14 patients that underwent a series of ECTs performed either with or without an approximately 0.5-mg/kg propofol bolus after the end of an electroencephalography (EEG) seizure. Among other values, we documented PIA incidence and severity as rated by a simple score; orientation to person, time, place, and situation; transfer times to the postanesthesia care (PACU) and inpatient unit; nurses' and patients' rating of recovery period, and others and tested for significant differences.
Five minutes after the end of ECT, the patients showed moderate to severe PIA in 8 of 37 ECT sessions. Incidence was significantly lower when patients had received propofol (3/37). Transfer time to the PACU was longer, but transfer time to the inpatient unit was shorter after administration of propofol. The recovery period was rated significantly better after propofol administration by nurses and patients.
A single bolus of propofol administered after the end of the seizure reduced the incidence of post-ECT PIA. The PACU staff and patients rated the emergence period significantly better when propofol was administered.
电抽搐治疗（ECT）后癫痫后激越（PIA）是一个主要的医学问题。这项观察性研究调查了 PIA 的发生率和严重程度，并评估了异丙酚作为一种治疗选择在患者人群中的应用。
该研究纳入了 14 名患者，他们在脑电图（EEG）发作结束后接受了一系列 ECT，其中一些患者在结束时给予约 0.5mg/kg 的异丙酚推注。除其他值外，我们记录了 PIA 的发生率和严重程度，采用简单评分评估；对人、时间、地点和情况的定向；到麻醉后护理病房（PACU）和住院病房的转移时间；护士和患者对恢复期的评估，以及其他评估，并测试了显著差异。
ECT 结束后 5 分钟，37 次 ECT 中有 8 次出现中到重度 PIA。当患者接受异丙酚时，发生率明显较低（3/37）。给予异丙酚后，PACU 的转移时间延长，但到住院病房的转移时间缩短。护士和患者对异丙酚给药后的恢复期评估明显更好。
在癫痫发作结束时给予异丙酚单次推注可降低 ECT 后 PIA 的发生率。PACU 工作人员和患者在给予异丙酚时对苏醒期的评价明显更好。
