Results
Title

Outcome of four pretreatment regimes on hemodynamics during electroconvulsive therapy: A double-blind randomized controlled crossover trial.

Authors

Parikh, Devangi Ashutosh; Garg, Sanchita Nitin; Dalvi, Naina Parag; Surana, Priyanka Pradip; Sannakki, Deepa; Tendolkar, Bharati Anil

Abstract

Context: Electroconvulsive therapy (ECT) is associated with tachycardia and hypertension.Aims: The aim of this study was to compare two doses of dexmedetomidine, esmolol, and lignocaine with respect to hemodynamics, seizure duration, emergence agitation (EA), and recovery profile.Methodology: Thirty patients undergoing ECT were assigned to each of the following pretreatment regimes over the course of five ECT sessions in a randomized crossover design: Group D1 (dexmedetomidine 1 μg/kg), Group D0.5 (dexmedetomidine0.5 μg/kg), Group E (esmolol 1 mg/kg), Group L (lignocaine 1 mg/kg), and Group C (saline as placebo) before induction. Heart rate (HR), mean arterial pressure (MAP), seizure duration, EA, and time to discharge were evaluated.Results: Groups D1, D0.5, and esmolol had significantly reduced response of HR, MAP compared to lignocaine and control groups at 1, 3, 5 min after ECT (P 0.05). Time to eye opening and time to discharge were comparable in all groups (P > 0.05) except Group D1 (P = 0.001). EA score was least in Group D1 (P = 0.000).Conclusion: Dexmedetomidine 1 μg/kg, 0.5 μg/kg, and esmolol produced significant amelioration of cardiovascular response to ECT without affecting seizure duration, results being best with dexmedetomidine 1 μg/kg. However, the latter has the shortcoming of delayed recovery.

Subjects

HEALTH outcome assessment; ELECTROCONVULSIVE therapy; HEMODYNAMICS; DEXMEDETOMIDINE; ESMOLOL; LIDOCAINE

Publication

Annals of Cardiac Anaesthesia, 2017, Vol 20, Issue 1, p93

ISSN

0971-9784

Publication type

Academic Journal

DOI

10.4103/0971-9784.197844