Department of Neuropsychiatry, Aichi Medical University, Aichi, Japan.
Psychiatry Clin Neurosci. 2014 Apr;68(4):270-4. doi: 10.1111/pcn.12122. Epub 2013 Dec 8.
Memory impairment is a potential major adverse effect of electroconvulsive therapy (ECT). Some reports have suggested that propofol, an intravenous anesthetic widely used for general anesthesia in ECT, can minimize adverse effects on memory and cognitive function following ECT. The relation between propofol blood level during ECT and memory impairment after the procedure is unknown. We aimed to determine the relation between predicted blood level of propofol administered by target-controlled infusion during ECT and memory impairment after the procedure.
Thirty-six patients who underwent a total of 260 series of ECT were enrolled as subjects. Anesthesia was induced with intravenous injection of propofol with a target-controlled infusion pump for predicting blood levels. Orientation and memory testing were performed after completion of ECT. In a subsequent analysis, subjects were divided into early memory recovery (n = 195) and late memory recovery (n = 65) groups. Likewise, for orientation testing,subjects were divided into early recovery (n = 193) and late recovery (n = 67) groups. In both groups, predicted blood propofol levels, total propofol dose, and other variables, such as number of ECT treatments, stimulus energy volume, and spike and slow wave time, were determined for comparison.
Predicted blood propofol levels and propofol total dose were significantly higher in the early memory recovery group, while no significant differences were observed for the other variables. As for orientation, there were no significant differences between the early and late orientation recovery groups.
Our data shows that the predicted blood propofol levels and the total dose influences memory impairment after the ECT.
记忆障碍是电惊厥疗法（ECT）的一种潜在的主要不良反应。一些报告表明，异丙酚是一种广泛用于 ECT 全身麻醉的静脉麻醉剂，它可以最大限度地减少 ECT 后对记忆和认知功能的不良影响。ECT 期间异丙酚的血药水平与术后记忆障碍之间的关系尚不清楚。我们旨在确定 ECT 期间通过靶控输注给予的预测异丙酚血药水平与术后记忆障碍之间的关系。
共纳入 36 例接受了总共 260 次 ECT 系列治疗的患者作为研究对象。使用靶控输注泵静脉注射异丙酚诱导麻醉以预测血药水平。ECT 完成后进行定向和记忆测试。在随后的分析中，将患者分为早期记忆恢复组（n=195）和晚期记忆恢复组（n=65）。同样，对于定向测试，将患者分为早期恢复组（n=193）和晚期恢复组（n=67）。在这两组中，比较了预测的异丙酚血药水平、异丙酚总剂量以及其他变量，如 ECT 治疗次数、刺激能量体积、尖波和慢波时间。
早期记忆恢复组的预测血异丙酚水平和异丙酚总剂量明显较高，而其他变量无显著差异。至于定向，早期和晚期定向恢复组之间没有显著差异。
我们的数据表明，预测的异丙酚血药水平和总剂量影响 ECT 后的记忆障碍。
