Fu W, White P F
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, 75235-9068, USA.
Anesthesiology. 1999 Feb;90(2):422-4. doi: 10.1097/00000542-199902000-00015.
Orally administered clonidine (0.2-0.3 mg) has been reported to decrease the acute hypertensive response to electroconvulsive therapy (ECT) without prolonging early recovery. This preliminary study was designed to evaluate the acute hemodynamic effects of the investigational alpha2-adrenergic agonist, dexmedetomidine, in patients undergoing a series of ECT treatments.
Six patients undergoing a series of three to six consecutive ECT treatments were studied according to a randomized, double-blind, placebo-controlled protocol All patients received either saline or dexmedetomidine, 0.5 or 1.0 microg/kg intravenously, 10-30 min before induction of anesthesia for ECT using a standardized anesthesia protocol. In addition to assessing the cardiovascular variables, the duration of seizure activity, degree of sedation, and time to discharge from the Phase I recovery unit were assessed.
Although dexmedetomidine produced dose-related increases in the level of sedation before the ECT procedure, it failed to decrease the peak blood pressure and heart rate responses after the ECT treatment. The 0.5 and 1.0 microg/kg doses of dexmedetomidine prolonged the times to orientation and to discharge from the Phase I unit.
The results of this pilot study suggest that dexmedetomidine (0.5-1.0 microg/kg given intravenously) is not beneficial in controlling the acute hyperdynamic response after ECT.
据报道，口服可乐定（0.2 - 0.3毫克）可降低对电休克治疗（ECT）的急性高血压反应，且不会延长早期恢复时间。这项初步研究旨在评估新型α2 - 肾上腺素能激动剂右美托咪定对接受一系列ECT治疗患者的急性血流动力学影响。
按照随机、双盲、安慰剂对照方案，对6例接受连续三至六次ECT治疗的患者进行研究。所有患者在使用标准化麻醉方案进行ECT麻醉诱导前10 - 30分钟，静脉注射生理盐水或0.5或1.0微克/千克右美托咪定。除评估心血管变量外，还评估了癫痫发作活动持续时间、镇静程度以及从I期恢复单元出院的时间。
尽管右美托咪定在ECT手术前产生了与剂量相关的镇静水平升高，但它未能降低ECT治疗后的血压峰值和心率反应。0.5和1.0微克/千克剂量的右美托咪定延长了定向时间和从I期单元出院的时间。
这项初步研究结果表明，静脉注射右美托咪定（0.5 - 1.0微克/千克）对控制ECT后的急性高动力反应并无益处。
