What is it about?
Thiopentone Sodium to Attenuate the Hemodynamic Stress Responses after Electroconvulsive Therapy
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Why is it important?
Modified electroconvulsive therapy (ECT) under anesthesia is an important in the treatment of severe, persistent depression; bipolar disorder and schizophrenia; especially resistant cases. However, it is commonly associated with acute hyper dynamic responses. Aims: To compare the effects of dexmedetomidine and esmolol on patients’ haemodynamics, motor seizure duration, and recovery times following ECT. Study Design: Randomised Prospective Double Blinded Study. Materials and Methods: 90 cases aged between 18 to 50 years belonging to ASA grade I and II were randomly divided into three groups with 30 each. Group A received normal saline (placebo), Group B received dexmedetomidine 1 μg/kg, and Group C received esmolol 1 mg/kg; before induction with thiopentone sodium 2 mg/kg and muscle relaxation with succinylcholine 0.75 mg/kg. Hemodynamic parameters were recorded at different time intervals. The seizure duration using arm isolation method and recovery times using post-anesthesia discharge scoring system (PADSS) were noted. Analysis: Data analysis was done using SPSS (Statistical product and service solutions) software trial version 21 for windows. Results were expressed as mean ±SD, proportions and percentages. One way ANOVA test was used to assess the significant differences between groups. Results: PostECT rise in hemodynamic parameters was significantly less in dexmedetomidine group as compared to esmolol and control group at 2, 4, 6, and 8 min using ANOVA test. There was no significant difference in seizure duration, emergence, and recovery among the three groups. Conclusions: Both drugs reduce the hyperdynamic response to ECT without affecting the seizure duration, but dexmedetomidine has more favourable response in view of stable vitals, smooth emergence and no adverse effect on recovery duration.
Perspectives
Modified electroconvulsive therapy (ECT) under anesthesia is an important in the treatment of severe, persistent depression; bipolar disorder and schizophrenia; especially resistant cases. However, it is commonly associated with acute hyper dynamic responses. Aims: To compare the effects of dexmedetomidine and esmolol on patients’ haemodynamics, motor seizure duration, and recovery times following ECT. Study Design: Randomised Prospective Double Blinded Study. Materials and Methods: 90 cases aged between 18 to 50 years belonging to ASA grade I and II were randomly divided into three groups with 30 each. Group A received normal saline (placebo), Group B received dexmedetomidine 1 μg/kg, and Group C received esmolol 1 mg/kg; before induction with thiopentone sodium 2 mg/kg and muscle relaxation with succinylcholine 0.75 mg/kg. Hemodynamic parameters were recorded at different time intervals. The seizure duration using arm isolation method and recovery times using post-anesthesia discharge scoring system (PADSS) were noted. Analysis: Data analysis was done using SPSS (Statistical product and service solutions) software trial version 21 for windows. Results were expressed as mean ±SD, proportions and percentages. One way ANOVA test was used to assess the significant differences between groups. Results: PostECT rise in hemodynamic parameters was significantly less in dexmedetomidine group as compared to esmolol and control group at 2, 4, 6, and 8 min using ANOVA test. There was no significant difference in seizure duration, emergence, and recovery among the three groups. Conclusions: Both drugs reduce the hyperdynamic response to ECT without affecting the seizure duration, but dexmedetomidine has more favourable response in view of stable vitals, smooth emergence and no adverse effect on recovery duration.
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This page is a summary of: A Comparison of Dexmedetomidine with Thiopentone Sodium Versus Esmolol with Thiopentone Sodium to Attenuate the Hemodynamic Stress Responses after Electroconvulsive Therapy, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6419.41.
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