Study on the cognitive protective effect and optimal dose of dexmedetomidine hydrochloride on modified electroconvulsive therapy in patients with severe depression
10.3969/j.issn.1671-8348.2024.09.008
- VernacularTitle:盐酸右美托咪定对重度抑郁患者改良电休克治疗的认知保护作用及最佳剂量研究
- Author:
Li CHEN
1
;
Hualong SU
;
Qiao LI
;
Pei TAN
Author Information
1. 重庆市精神卫生中心麻醉科 重庆 400036
- Keywords:
dexmedetomidine hydrochloride;
severe depression;
improved electroconvulsive therapy;
cognitive protection;
optimum dose
- From:
Chongqing Medicine
2024;53(9):1323-1327,1332
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the cognitive protective effect and optimal dose of dexmedetomidine hydrochloride (DEX) in patients with severe depression treated with modified electroconvulsive therapy (MECT).Methods A total of 120 patients with severe depression in our hospital from June 2021 to Decem-ber 2022 were randomly divided into DEX group (D1,D2,D3 group) and control group,with 30 cases in each group.DEX 0.2,0.4,and 0.6 μg/kg were intravenously pumped 10 min before anesthesia in groups D1,D2, and D3,respectively,and the same volume of normal saline was pumped in the control group.The heart rate (HR),mean arterial pressure (MAP),spontaneous breathing recovery time,recovery time,mini-mental state examination (MMSE) score at T0,one d and three d after operation,and adverse reactions were compared a-mong the four groups before anesthesia (T0),10 min after infusion of DEX (T1),after anesthesia induction and loss of consciousness (T2),at the end of MECT (T3),and five min after MECT (T4).Results At T1 and T2,HR in group D1 and HR and MAP in groups D2 and D3 were lower than those at T0,and the differences were statistically significant (P<0.05).At T3,the HR and MAP of the four groups reached the peak,but at T4,the HR and MAP gradually decreased.At T4,the HR and MAP of the control group were higher than those at T0,and the HR and MAP of the D2 and D3 groups were lower than those at T0,the differences were statistically significant (P<0.05).The recovery time of spontaneous breathing in D1,D2 and D3 groups was shorter than that in the control group,and the dosage of propofol was lower than that in the control group,the differences were statistically significant (P<0.05).The recovery time from long to short was D3,D2 and D1 group,and the difference was statistically significant (P<0.05).At one d and three d after operation,the MMSE scores of D1,D2 and D3 groups were higher than those of the control group,and the MMSE score of D3 group was the highest,the difference was statistically significant (P<0.05).Conclusion DEX can reduce MECT stress response and postoperative adverse reactions in patients with severe depression in a dose-de-pendent manner,and protect cognitive function.
