Application effect and optimal dosage of dexmedetomidine pretreatment in modified electroconvulsive therapy
Objective To investigate the application efficacy and optimal dosage of dexmedetomidine precondition-ing in modified electroconvulsive therapy(MECT)and to explore its optimal dose.Methods Two hundred and fifty-two patients who were to undergo MECT were selected and were randomly divided into group D1,group D2,group D3,group D4,group D5 and control group,respectively,with 42 cases in each.Ten min before anaesthesia induction,0.2,0.4,0.6,0.8 and 1.0 μg/kg dexmedetomidine hydrochloride was intravenously pumped into the D1,D2,D3,D4 and D5 groups,respectively,and the control group was intravenously pumped with an equal volume of normal saline 30 mL;the patients were treated by a MECT therapeutic instrument.Heart rate(HR)and mean arterial pressure(MAP)were record-ed in each group at the immediate moment of dexmedetomidine pretreatment(T1),5 min after pretreatment(T2),10 min after pretreatment(T3),15 min after pretreatment(T4),20 min after pretreatment(T5),25 min after pretreatment(T6),and 30 min after pretreatment(T7),respectively;and the duration of seizure,the dose of propofol used during MECT,the recovery time of spontaneous respiration,the awakening time and the occurrence of adverse reactions were compared be-tween the groups.Results Compared with the control group at the same time point,HR was reduced in the group D1 at T4,and in the groups D2,D3,D4,and D5 at T2 to T7;and MAP was reduced in the group D2 at T4 to T7,and in the groups D3,D4,and D5 at T2 to T7(all P<0.05).Compared with the same group at T1,HR was reduced in the groups D4 and D5 at T7;MAP was reduced in the groups D3,D4 and D5 at T7(all P<0.05).There was no statistically significant dif-ference in seizure duration among groups(all P>0.05);the dosage of propofol was less in the groups D2,D3,D4,and D5 than in the control group;the recovery time of spontaneous respiration was longer in the groups D4 and D5 than in the con-trol group;the time of awakening was longer in the groups D3,D4,and D5 than in the control group;and the incidence rate of adverse reactions was lower in the groups D1,D2,D3,D4,and D5 than in the control group(all P<0.05).Com-clusion Dexmedetomidine pretreatment can effectively reduce the haemodynamic fluctuation of MECT patients,reduce the dose of anaesthesia drugs,improve the quality of anaesthesia recovery,and has better safety;in MECT,pretreatment with 0.4 μg/kg dexmedetomidine has the best effect.
万方数据
维普
