Aaron Olurotimi I, Faponle Aramide F, Bolaji Benjamin O, Mosaku Samuel K, Adenekan Anthony T, Oginni Olakunle A
Department of Anesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Nigeria.
Department of Anesthesia and Intensive Care, University of Ilorin, Ilorin, Nigeria.
Saudi J Anaesth. 2020 Oct-Dec;14(4):487-492. doi: 10.4103/sja.SJA_147_20. Epub 2020 Sep 24.
Suxamethonium has been shown to have a superior modification of the convulsion associated with ECT compared to other muscle relaxants. The dosage of suxamethonium used in ECT varies widely based on the experiences of practitioners. The study aimed to determine and compare the effectiveness and side effect profile of 0.5 mg/kg and 1 mg/kg in modified ECT.
This was a prospective randomized crossover study, comparing the effects of suxamethonium at a dose of 0.5 mg/kg, and 1.0 mg/kg in 27 patients who had a total of 54 sessions of modified ECT. The primary outcome parameters were quality of convulsion and onset and duration of apnoea. The secondary outcome parameters were hemodynamic variables, arterial oxygen saturation, delayed recovery, muscle pain, vomiting, headache, prolonged convulsion, and serum potassium. Data collected were entered into proforma and analyzed using Statistical Package for Social Sciences (SPSS) version 17.0. Parametric variables are presented as means and standard deviations while non-parametric variables are presented as frequencies and percentages. The level of significance (P-value) was considered at 0.05.
Sixteen patients (59%) had acceptable convulsion modification with 0.5 mg/kg suxamethonium compared to 23 patients (85%) with the use of 1.0 mg/kg suxamethonium ( = 0.016). There was no statistically significant difference in the duration of convulsion, the onset of apnoea, and the duration of apnoea with the two doses. Changes in heart rate, blood pressure, arterial oxygen saturation, and serum potassium level that accompany the mECT were comparable with the two doses of suxamethonium studied.
A better modification of convulsion with comparable hemodynamic and side effect profile is achieved during mECT with the use of 1.0 mg/kg suxamethonium compared to 0.5 mg/kg.
与其他肌肉松弛剂相比，已证明琥珀胆碱对与电休克治疗（ECT）相关的惊厥具有更好的改善作用。ECT中使用的琥珀胆碱剂量因从业者的经验而异。本研究旨在确定并比较改良ECT中0.5mg/kg和1mg/kg剂量的有效性和副作用情况。
这是一项前瞻性随机交叉研究，比较了27例接受总计54次改良ECT治疗的患者使用0.5mg/kg和1.0mg/kg剂量琥珀胆碱的效果。主要结局参数为惊厥质量、呼吸暂停的起始和持续时间。次要结局参数为血流动力学变量、动脉血氧饱和度、延迟恢复、肌肉疼痛、呕吐、头痛、惊厥延长和血清钾。收集的数据录入表格，并使用社会科学统计软件包（SPSS）17.0版进行分析。参数变量以均值和标准差表示，而非参数变量以频率和百分比表示。显著性水平（P值）设定为0.05。
与使用1.0mg/kg琥珀胆碱的23例患者（85%）相比，16例患者（59%）使用0.5mg/kg琥珀胆碱时惊厥得到了可接受的改善（P = 0.016）。两种剂量在惊厥持续时间、呼吸暂停起始和呼吸暂停持续时间方面无统计学显著差异。两种研究剂量的琥珀胆碱伴随改良ECT出现的心率、血压、动脉血氧饱和度和血清钾水平变化相当。
与0.5mg/kg相比，改良ECT期间使用1.0mg/kg琥珀胆碱可实现更好的惊厥改善，且血流动力学和副作用情况相当。
