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Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation

BACKGROUND AND AIMS: The choice of anaesthetic agent for electroconvulsive therapy (ECT) depends on seizure duration, haemodynamic, and recovery parameters. The aim of the study was to assess the effects of ketamine-propofol induction with dexmedetomidine preadministration (ketofol-dex group) and wi...

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Autores principales: Shams, Tarek, El-Masry, Ragaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090992/
https://www.ncbi.nlm.nih.gov/pubmed/25024469
http://dx.doi.org/10.4103/0019-5049.135037
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author Shams, Tarek
El-Masry, Ragaa
author_facet Shams, Tarek
El-Masry, Ragaa
author_sort Shams, Tarek
collection PubMed
description BACKGROUND AND AIMS: The choice of anaesthetic agent for electroconvulsive therapy (ECT) depends on seizure duration, haemodynamic, and recovery parameters. The aim of the study was to assess the effects of ketamine-propofol induction with dexmedetomidine preadministration (ketofol-dex group) and without its preadministration (ketofol group) on haemodynamics, depression, seizure duration, recovery characteristics, and agitation following ECT in patients with depression. METHODS: 40 patients aged 18-60 years were scheduled for ECT for treatment of depression. Dexmedetomidine (0.5 μg/kg) diluted to a volume of 10 ml with 0.9% saline or 10 ml 0.9% saline were infused intravenously over 10 minutes before induction of anaesthesia with ketamine and propofol (ketofol). Statistical analysis was carried out using the Statistical Software for the Social Sciences (SPSS) package. RESULTS: Motor seizure duration in ketofol group was significantly less compared to ketofol-dex group (35.8 ± 6.6s versus 38.9 ± 4.9s). Total ketofol used was significantly less in ketofol-dex group compared to ketofol group (78.5 ± 10.8mg versus 90 ± 13.2mg). The number of patients with agitation score >2 was significantly lower in ketofol-dex group (1.4%) compared to ketofol group (8.6%). There was significant decrease (P = 0.000) in mean arterial pressure (MAP) and heart rate (HR) in ketofol-dex group compared to ketofol group at 20, 30, and 40 minutes for MAP and at 10, 20, 30, and 40 minutes for HR. CONCLUSIONS: Ketofol-dex mixture in ECT is associated with longer mean seizure duration, effective anti-depression, less incidence of agitation, more patient satisfaction, and acceptable decreases in blood pressure and HR when compared to ketofol alone.
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spelling pubmed-40909922014-07-14 Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation Shams, Tarek El-Masry, Ragaa Indian J Anaesth Clinical Investigation BACKGROUND AND AIMS: The choice of anaesthetic agent for electroconvulsive therapy (ECT) depends on seizure duration, haemodynamic, and recovery parameters. The aim of the study was to assess the effects of ketamine-propofol induction with dexmedetomidine preadministration (ketofol-dex group) and without its preadministration (ketofol group) on haemodynamics, depression, seizure duration, recovery characteristics, and agitation following ECT in patients with depression. METHODS: 40 patients aged 18-60 years were scheduled for ECT for treatment of depression. Dexmedetomidine (0.5 μg/kg) diluted to a volume of 10 ml with 0.9% saline or 10 ml 0.9% saline were infused intravenously over 10 minutes before induction of anaesthesia with ketamine and propofol (ketofol). Statistical analysis was carried out using the Statistical Software for the Social Sciences (SPSS) package. RESULTS: Motor seizure duration in ketofol group was significantly less compared to ketofol-dex group (35.8 ± 6.6s versus 38.9 ± 4.9s). Total ketofol used was significantly less in ketofol-dex group compared to ketofol group (78.5 ± 10.8mg versus 90 ± 13.2mg). The number of patients with agitation score >2 was significantly lower in ketofol-dex group (1.4%) compared to ketofol group (8.6%). There was significant decrease (P = 0.000) in mean arterial pressure (MAP) and heart rate (HR) in ketofol-dex group compared to ketofol group at 20, 30, and 40 minutes for MAP and at 10, 20, 30, and 40 minutes for HR. CONCLUSIONS: Ketofol-dex mixture in ECT is associated with longer mean seizure duration, effective anti-depression, less incidence of agitation, more patient satisfaction, and acceptable decreases in blood pressure and HR when compared to ketofol alone. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4090992/ /pubmed/25024469 http://dx.doi.org/10.4103/0019-5049.135037 Text en Copyright: © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigation
Shams, Tarek
El-Masry, Ragaa
Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation
title Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation
title_full Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation
title_fullStr Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation
title_full_unstemmed Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation
title_short Ketofol-Dexmedetomidine combination in ECT: A punch for depression and agitation
title_sort ketofol-dexmedetomidine combination in ect: a punch for depression and agitation
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090992/
https://www.ncbi.nlm.nih.gov/pubmed/25024469
http://dx.doi.org/10.4103/0019-5049.135037
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