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Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial

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: Thir...

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Autores principales: Parikh, Devangi Ashutosh, Garg, Sanchita Nitin, Dalvi, Naina Parag, Surana, Priyanka Pradip, Sannakki, Deepa, Tendolkar, Bharati Anil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290705/
https://www.ncbi.nlm.nih.gov/pubmed/28074804
http://dx.doi.org/10.4103/0971-9784.197844
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author Parikh, Devangi Ashutosh
Garg, Sanchita Nitin
Dalvi, Naina Parag
Surana, Priyanka Pradip
Sannakki, Deepa
Tendolkar, Bharati Anil
author_facet Parikh, Devangi Ashutosh
Garg, Sanchita Nitin
Dalvi, Naina Parag
Surana, Priyanka Pradip
Sannakki, Deepa
Tendolkar, Bharati Anil
author_sort Parikh, Devangi Ashutosh
collection PubMed
description 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). Motor seizure duration was comparable in all groups except Group L (P = 0.000). Peak HR was significantly decreased in all groups compared to control. Total propofol requirement was reduced in D1 (P = 0.000) and D0.5 (P = 0.001) when compared to control. Time to spontaneous breathing was comparable in all the groups (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.
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spelling pubmed-52907052017-02-17 Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial Parikh, Devangi Ashutosh Garg, Sanchita Nitin Dalvi, Naina Parag Surana, Priyanka Pradip Sannakki, Deepa Tendolkar, Bharati Anil Ann Card Anaesth Original Article 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). Motor seizure duration was comparable in all groups except Group L (P = 0.000). Peak HR was significantly decreased in all groups compared to control. Total propofol requirement was reduced in D1 (P = 0.000) and D0.5 (P = 0.001) when compared to control. Time to spontaneous breathing was comparable in all the groups (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. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5290705/ /pubmed/28074804 http://dx.doi.org/10.4103/0971-9784.197844 Text en Copyright: © 2017 Annals of Cardiac 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-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Parikh, Devangi Ashutosh
Garg, Sanchita Nitin
Dalvi, Naina Parag
Surana, Priyanka Pradip
Sannakki, Deepa
Tendolkar, Bharati Anil
Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial
title Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial
title_full Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial
title_fullStr Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial
title_full_unstemmed Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial
title_short Outcome of Four Pretreatment Regimes on Hemodynamics during Electroconvulsive Therapy: A Double-blind Randomized Controlled Crossover Trial
title_sort outcome of four pretreatment regimes on hemodynamics during electroconvulsive therapy: a double-blind randomized controlled crossover trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290705/
https://www.ncbi.nlm.nih.gov/pubmed/28074804
http://dx.doi.org/10.4103/0971-9784.197844
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