Mir Altaf Hussain, Shah Nida Farooq, Din Mehraj Ud, Langoo Shabir Ahmad, Reshi Fayaz Ahmad
Department of Anaesthesiology, Government Medical College, Srinagar, Jammu and Kashmir, India.
Department of Anaesthesiology and Critical Care, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Saudi J Anaesth. 2017 Jan-Mar;11(1):26-31. doi: 10.4103/1658-354X.197339.
Electroconvulsive therapy (ECT) is a well-established psychiatric treatment in which seizures are electrically induced in patients for therapeutic effects. ECT can produce severe disturbances in the cardiovascular system and a marked increase in cerebral blood flow and intracranial pressure. These cardiovascular changes may be altered using various anesthetic drugs.
This study was undertaken to compare the effects of intravenous (IV) sodium thiopentone, propofol, and etomidate, used as IV anesthetic agents in modified ECT as regards, induction time and quality of anesthesia, alteration of hemodynamics, seizure duration, and recovery time.
A total of 90 patients in the age group of 16-60 years of either sex, who had to undergo ECT therapy were divided randomly into three equal groups. Group A received propofol 1% - 1.5 mg/Kg, Group B received etomidate - 0.2 mg/Kg, and Group C received thiopentone 2.5% - 5 mg/Kg. All the patients were monitored for changes in heart rate, systolic blood pressure, diastolic blood pressure, and oxygen saturation at basal, after induction and 1 min, 2 min, 3 min, 5 min, 10 min, 20 min, and 30 min following ECT. Quality of anesthesia, seizure duration, and recovery times were also recorded.
We found that propofol had the advantage of smooth induction, stable hemodynamic parameters and rapid recovery as compared to etomidate and thiopentone. Thiopentone had the advantage over propofol of having longer seizure duration at the cost of a relatively prolonged recovery period. Etomidate had a definite advantage of longer seizure duration.
电休克疗法（ECT）是一种成熟的精神科治疗方法，通过对患者进行电刺激诱发癫痫发作以达到治疗效果。ECT可引起心血管系统的严重紊乱，并使脑血流量和颅内压显著增加。使用各种麻醉药物可能会改变这些心血管变化。
本研究旨在比较静脉注射硫喷妥钠、丙泊酚和依托咪酯作为改良ECT静脉麻醉剂时，在诱导时间、麻醉质量、血流动力学改变、癫痫发作持续时间和恢复时间方面的效果。
共有90例年龄在16至60岁之间、需接受ECT治疗的患者，不分性别，随机分为三组，每组人数相等。A组接受1% - 1.5mg/kg丙泊酚，B组接受0.2mg/kg依托咪酯，C组接受2.5% - 5mg/kg硫喷妥钠。在基础状态、诱导后以及ECT后1分钟、2分钟、3分钟、5分钟、10分钟、20分钟和30分钟，对所有患者的心率、收缩压、舒张压和血氧饱和度变化进行监测。同时记录麻醉质量、癫痫发作持续时间和恢复时间。
我们发现，与依托咪酯和硫喷妥钠相比，丙泊酚具有诱导平稳、血流动力学参数稳定和恢复迅速的优点。硫喷妥钠的优势在于癫痫发作持续时间较长，但恢复时间相对延长。依托咪酯的明显优势是癫痫发作持续时间更长。
