摘要
目的观察依托咪酯(etomidate)和丙泊酚(propofol)对无抽搐电痉挛治疗(MECT)脑电发作时间和心血管反应的影响。方法将60例精神分裂症患者分为依托咪酯组和丙泊酚组,各30例。丙泊酚组接受丙泊酚麻醉MECT3次;依托咪酯组接受依托咪酯麻醉MECT3次;依托咪酯组另接受丙泊酚麻醉MECT3次,为依托咪酯自身对照组。分别于每次MECT麻醉前、麻醉后、电刺激后1min、3min及5min末记录心率和血压,同时记录MECT脑电发作时间及抑制指数。结果与麻醉前比较,麻醉后及电刺激后依托咪酯组与丙泊酚组心率均加快(P<0.01)。与麻醉前比较,麻醉后丙泊酚组及依托咪酯自身对照组收缩压和舒张压均明显降低(P<0.01),但电刺激后能恢复正常;而依托咪酯组则与麻醉前比较无差异,但电刺激后血压慢性升高(P<0.01)。与丙泊酚组及依托咪酯自身对照组相比,依托咪酯组脑电发作持续时间延长(P<0.01);而在抑制指数上则三组之间无差异。结论依托咪酯较丙泊酚延长MECT脑电发作时间,提高发作质量。与依托咪酯比较,丙泊酚有预防血压升高作用。
Objective： To explore the effects of etomidate and propofol on the duration of seizure and cardiovascular reactions in modified electroconvulsive therapy （MECT）. Methods： Sixty schizophrenic patients were divided into etomidate group and propofol group . There were 30 subjects in each group. Patients in propofol group were anesthetized with propofol and treated with MECT for three times. Patients in etomidate group were anesthetized with etomidate treated with MECT for three times, then these patients were anesthetized with propofol and treated with MECT for anther three times. The heart beat rates and blood pressure were measured and recorded before and after anesthesia, 1minute, 3minutes, and 5 minutes after the electrical stimulus. The duration of seizure and restraining index were recorded during MECT. Results：Compared to the patients＇heart beats before the anesthesia, the heart beats increased after anesthesia and electrical stimulus（ P 〈 0.01 ）. The systolic pressure and the diastolic pressure beth decreased significantly in propofol group and etomidate auto controlled group, but they were improved to the normal level after the electrical stimulus. The patients＇ blood pressure and did not changed significantly in etomidate group after anesthesia and the blood pressure increased chronically after the electrical stimulus（ P 〈 0.01 ）. The duration of seizure was longer in etomidate group than that in propofol group and etomidate auto controlled group （ P 〈 0.01 ）. There were no significant differences in the restraining index among the three groups. Conclusion： Etomidate can prolong the duration of seizure during MECT and improve the seizure＇s effect. Propofol can prevent an increase in blood pressure.
出处
《上海精神医学》
2009年第3期169-171,175,共4页
Shanghai Archives of Psychiatry
