Optimization strategy of anesthesia for modified electroconvulsive therapy in patients with major depressive disorder: low-dose esketamine combined with propofol
10.3760/cma.j.cn131073.20211110.00309
- VernacularTitle:重度抑郁症患者MECT麻醉的优化策略：小剂量艾司氯胺酮复合丙泊酚
- Author:
Yue ZHANG
1
;
Fei XING
;
Erxian ZHAO
;
Jianjun YANG
;
Yunqi LYU
Author Information
1. 郑州大学第一附属医院麻醉与围术期医学部，郑州 450052
- Keywords:
Depressive disorder;
Electroconvulsive therapy;
Propofol;
Esketamine
- From:
Chinese Journal of Anesthesiology
2022;42(3):294-297
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the optimization efficacy of low-dose esketamine combined with propofol in the patients with major depressive disorder undergoing modified electroconvulsive therapy (MECT).Methods:Fifty-six American Society of Anesthesiologists physical statusⅠor Ⅱ patients, aged 18-64 yr, scheduled for MECT for the first time, were assigned into esketamine plus propofol group (group EP, n=28) and propofol group (group P, n=28) according to a ratio of 1∶1 by the random number table method.Esketamine 0.25 mg/kg was intravenously injected before anesthesia induction in group EP, while the equal volume of normal saline was given instead in group P. Propofol and succinylcholine were then intravenously injected to perform MECT in two groups.The primary outcomes were the remission rate and response rate, and the secondary outcomes included the number of MECT required for response and remission, the seizure duration, energy inhibition index and consumption of propofol for each MECT, and the occurrence of therapy-related adverse reactions and relapse. Results:Compared with group P, the remission rate and response rate were significantly increased, and the number of MECT required for response and remission was decreased, the seizure duration was prolonged, and energy inhibition index was increased, the consumption of propofol was reduced ( P<0.05), and no significant change was found in the incidence of therapy-related adverse reactions and relapse in group EP ( P>0.05). Conclusions:Low-dose esketamine combined with propofol can enhance the efficacy of MECT and shorten the course of therapy without increasing therapy-related adverse reactions in the patients with major depression.
