Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Anesthesiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
J Chin Med Assoc. 2017 Aug;80(8):476-481. doi: 10.1016/j.jcma.2017.02.008.
Acute hemodynamic responses to electroconvulsive therapy (ECT) may increase the risk of cardiovascular complications in vulnerable patients. The aim of the current study was to assess the effect of small-dose dexmedetomidine on hyperdynamic responses to ECT.
Seventy-eight patients were enrolled and randomly allocated to receive either 0.2 μg/kg dexmedetomidine (Dex group, n = 39) or saline (Control group, n = 39) prior to ECT. Heart rate (HR) and mean arterial pressure (MAP) were recorded immediately after the administration of dexmedetomidine (T1), and 0, 1, 3, 5 and 10 min after the electrical stimuli ended (T2, T3, T4, T5 and T6). In addition, the peak HR after ECT, seizure duration, recovery time, and incidence rates of post-ECT adverse effects (agitation, headache and nausea) were also recorded.
HR and MAP in the Dex group were significantly lower than those in the Control group from T2 to T5. In addition, peak HR was significantly lower in the Dex group compared with that in the Control group. Seizure length and time to spontaneous breathing, eye opening, and obeying commands in the Dex group were similar to those in the Control group. The incidence rates of post-ECT agitation and headache in the Dex group were significantly lower than that in the Control group.
The administration of 0.2 μg/kg dexmedetomidine to patients receiving ECT leads to a significant reduction in HR, MAP, and peak HR responses to ECT without altering seizure duration or delaying recovery. Furthermore, dexmedetomidine effectively reduced the incidence rates of post-ECT adverse effects such as agitation and headache.
电抽搐治疗（ECT）的急性血液动力学反应可能会增加脆弱患者发生心血管并发症的风险。本研究的目的是评估小剂量右美托咪定对 ECT 高动力反应的影响。
纳入 78 例患者，并随机分为右美托咪定（Dex 组，n=39）或生理盐水（对照组，n=39）组，在 ECT 前给药。记录右美托咪定给药后即刻（T1）、电刺激结束后 0、1、3、5 和 10 分钟（T2、T3、T4、T5 和 T6）时的心率（HR）和平均动脉压（MAP）。此外，还记录了 ECT 后的最大 HR、癫痫持续时间、恢复时间以及 ECT 后不良反应（激越、头痛和恶心）的发生率。
与对照组相比，Dex 组从 T2 到 T5 时 HR 和 MAP 明显更低。此外，Dex 组的最大 HR 明显低于对照组。Dex 组的癫痫持续时间和自主呼吸、睁眼、听从指令的恢复时间与对照组相似。Dex 组 ECT 后激越和头痛的发生率明显低于对照组。
对接受 ECT 的患者给予 0.2μg/kg 右美托咪定可显著降低 HR、MAP 和 ECT 对 HR 的峰值反应，而不改变癫痫持续时间或延迟恢复。此外，右美托咪定有效地降低了 ECT 后不良反应（如激越和头痛）的发生率。
