Chen Xuemeng, Zhou Rui, Lan Lan, Zhu Ling, Chen Cheng, Zhang Xianjie, Han Jia, Xia Leqiang
Department of Anesthesiology, Deyang People's Hospital, Deyang City, Sichuan Province, People's Republic of China.
Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 May 17;20:1107-1115. doi: 10.2147/NDT.S463028. eCollection 2024.
Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing comprehensive treatment outcomes for depression.
This study was a prospective, randomized, controlled, double-blind trial involving subjects and evaluators. One hundred eleven patients scheduled for ECT were randomly assigned to three groups. In Group P, propofol at 1mg/kg was administered intravenously. In Group P+E, propofol at a dosage of 0.5mg/kg and esketamine at a dosage of 0.5mg/kg was administered intravenously. Patients in Group P+SE received propofol at a dosage of 0.75mg/kg and esketamine at a dosage of 0.25mg/kg. The same anesthesia protocol was used for the same patient until the end of the last treatment. The primary outcome measures were the Hamilton depression scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9), the Columbia-Suicide Severity Rating Scale (C-SSRS), and the Digit symbol substitution test (DSST). Secondary outcomes included length of hospital stay, readmission rate, hemodynamic status, recovery, and adverse events.
This study aimed to compare the effects of propofol combined with different doses of esketamine for ECT. The results may provide a better choice for ECT anesthesia.
重度抑郁症（MDD）是一种常见的情绪障碍。电休克疗法（ECT）对难治性MDD有显著疗效。艾司氯胺酮在提高ECT疗效方面可能具有潜在优势，且该化合物对N-甲基-D-天冬氨酸受体（NMDAR）具有很强的亲和力，使其成为治疗抑郁症的可行治疗选择。本研究旨在比较不同剂量的艾司氯胺酮联合丙泊酚麻醉与单纯丙泊酚麻醉在ECT中的效果，旨在为优化ECT及提高抑郁症综合治疗效果提供进一步的见解。
本研究是一项涉及受试者和评估者的前瞻性、随机、对照、双盲试验。111例计划接受ECT的患者被随机分为三组。P组静脉注射1mg/kg丙泊酚。P + E组静脉注射0.5mg/kg丙泊酚和0.5mg/kg艾司氯胺酮。P + SE组患者接受0.75mg/kg丙泊酚和0.25mg/kg艾司氯胺酮。对同一患者采用相同的麻醉方案，直至最后一次治疗结束。主要观察指标为汉密尔顿抑郁量表（HAMD）、患者健康问卷-9（PHQ-9）、哥伦比亚自杀严重程度评定量表（C-SSRS）和数字符号替换测验（DSST）。次要观察指标包括住院时间、再入院率、血流动力学状态、恢复情况及不良事件。
本研究旨在比较丙泊酚联合不同剂量艾司氯胺酮用于ECT的效果。结果可能为ECT麻醉提供更好的选择。
