Tanaka N, Saito Y, Hikawa Y, Nakazawa K, Yasuda K, Amaha K
Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University.
Masui. 1997 Dec;46(12):1575-9.
The effect of thiopental and sevoflurane (1 MAC, 2 MAC) on hemodynamics was assessed in a randomized study involving 38 adult patients undergoing electroconvulsive therapy (ECT). Blood pressure, heart rate and electrocardiogram (ECG) were monitored during the ECT procedure. After oxygenation, hypnosis was induced with a bolus injection of thiopenal (TPS) 4 mg.kg-1. Muscle relaxation was achieved by succinylcholine, 1 mg.kg-1 intravenously before ECT procedure. Ventilation was assisted using a face mask with 100% oxygen (TPS group), 1.7% sevoflurane (1 MAC group) or 3.4% sevoflurane (2 MAC group), plus 50% nitrous oxide and 50% oxygen. Thereafter, an electrical stimulus was administered. A total of 150 treatment sessions were evaluated. The rate pressure product increased in every group right after ECT, but the use of sevoflurane (2 MAC) significantly diminished the response compared with sevoflurane (1 MAC) and thiopental. In the sevoflurane (2 MAC) group, no ventricular arrhythmias were observed. In general, it seems that sevoflurane (2 MAC) is as effective as thiopental and sevoflurane (1 MAC) as an induction agent for ECT.
在一项随机研究中，对38例接受电休克治疗（ECT）的成年患者评估了硫喷妥钠和七氟醚（1MAC、2MAC）对血流动力学的影响。在ECT过程中监测血压、心率和心电图（ECG）。氧合后，静脉推注4mg·kg-1硫喷妥钠（TPS）诱导催眠。在ECT手术前静脉注射1mg·kg-1琥珀酰胆碱实现肌肉松弛。使用面罩辅助通气，面罩内为100%氧气（TPS组）、1.7%七氟醚（1MAC组）或3.4%七氟醚（2MAC组），加50%氧化亚氮和50%氧气。此后，给予电刺激。共评估了150个治疗疗程。ECT后每组的心率血压乘积均升高，但与七氟醚（1MAC）和硫喷妥钠相比，使用七氟醚（2MAC）显著降低了反应。在七氟醚（2MAC）组中，未观察到室性心律失常。总体而言，七氟醚（2MAC）作为ECT的诱导剂似乎与硫喷妥钠和七氟醚（1MAC）一样有效。
