右美托咪定用于改良电休克治疗：一项剂量优化治疗研究。

Dexmedetomidine for modified electroconvulsive therapy: a dose-optimized treatment study.

作者信息

Shen Jun, Zhou Min, Zhu Guangliang, Zhang Yu, Ma Jinzhi, Li Dekui, Chen Lei, Qi Kejun, Wang Anjiang, Jiang Yang, Dai Zhiming, Li Xiaoming

机构信息

Department of Anesthesiology, Affiliated Hospital of West Anhui Health Vocational College, Lu'an, Anhui, 237000, People's Republic of China.

Department of Psychiatry, Lu'an Mental Health Center, Lu'an, Anhui, 237000, People's Republic of China.

出版信息

Eur J Med Res. 2025 Apr 4;30(1):241. doi: 10.1186/s40001-025-02509-3.

DOI:10.1186/s40001-025-02509-3

PMID:40186322

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11969942/

Abstract

OBJECTIVES

To determine the optimal dexmedetomidine dose for hemodynamic stability and recovery quality in modified electroconvulsive therapy (MECT).

METHODS

In this randomized trial, 252 patients receiving MECT were allocated to six groups (placebo, D1-D5; 42/group). Groups D1-D5 received dexmedetomidine (0.2-1.0 μg/kg) 10 min pre-anesthesia, while controls received saline. Hemodynamic parameters heart rate (HR), mean arterial pressure (MAP), seizure duration, propofol requirements, recovery times, and adverse events were analyzed.

RESULTS

Doses ≥ 0.4 μg/kg (D2-D5) significantly reduced HR and MAP versus control (P < 0.05), with prolonged recovery in D4-D5 (P < 0.05). Seizure duration remained unchanged across groups. Propofol use decreased dose-dependently (D2-D5, P < 0.05). The D2 group (0.4 μg/kg) achieved optimal hemodynamic stability without excessive recovery delays.

CONCLUSIONS

Dexmedetomidine pretreatment at 0.4 μg/kg optimizes MECT anesthesia by balancing hemodynamic control, reduced propofol use, and rapid recovery, establishing it as the recommended dose.

摘要

目的

确定在改良电休克治疗（MECT）中实现血流动力学稳定和恢复质量的右美托咪定最佳剂量。

方法

在这项随机试验中，252例接受MECT的患者被分为六组（安慰剂组、D1 - D5组；每组42例）。D1 - D5组在麻醉前10分钟接受右美托咪定（0.2 - 1.0μg/kg），而对照组接受生理盐水。分析血流动力学参数心率（HR）、平均动脉压（MAP）、癫痫持续时间、丙泊酚需求量、恢复时间和不良事件。

结果

与对照组相比，剂量≥0.4μg/kg（D2 - D5组）显著降低了HR和MAP（P < 0.05），D4 - D5组恢复时间延长（P < 0.05）。各组癫痫持续时间保持不变。丙泊酚使用量呈剂量依赖性减少（D2 - D5组，P < 0.05）。D2组（0.4μg/kg）实现了最佳血流动力学稳定性，且无过度恢复延迟。