MECT治疗前后麻醉药物对血压的影响

Effects of anethetics on BP when patients receiving modified electroconvulsive therapy

目的探讨无抽搐电休克治疗时不同麻醉药品对患者心率及血压的影响。方法将90例MECT治疗适应症患者随机分为A、B、C三组各30例,三组均首先静脉注射阿托品,然后分别静脉注射硫喷妥钠、依托咪脂、丙泊酚,再分别静脉注射琥珀酰胆碱,于麻醉前、麻醉后、刺激时、刺激后2min、4min末分别记录两组的心率、平均动脉压。结果平均动脉压除A组麻醉后、C组通电2min末、4min末与麻醉前无显著性差异(P>0.05)外,三组其它各时点测评均显著高于麻醉前(P<0.01);C组麻醉后显著低于A、B两组(P<0.01);A组麻醉后显著低于B组(P<0.05)。心率测评三组麻醉后各时点均显著高于麻醉前(P<0.01);C组在刺激时显著低于A、B两组(P<0.01),其它各时点三组间比较均无显著性差异(P>0.05)。结论丙泊酚用于MECT治疗麻醉诱导时,能有效控制患者应激而导致的心率加快、血压骤升等应激反应,可作为首选麻醉药品。

Objective To explore the effects of different anethetics on patients＇ HR and BP when receiving modified eleetroeonvulsive therapy（MECT）. Methods 90 patients meeting MECT indietion were randomiy divided into 3 groups（ each n=30）, first the 3 groups were anesthetized with atropine, next Sod Pent, etomidate and propofol, finally sueeinyeholine, respectively. HRs and MAPs of both groups were recorded before and after anesthesia, in stimulating, at the ends of the 2nd and 4th minute after stimulating. Results There were no significant differences in the MAP except after anethesia in the group A and at the ends of the 2nd and 4th minute after stimulating in the group C （P〉0. 05）, the other time-point measurements of the 3 groups were all very significantly higher（P〈0.01） compared with pre-anesthesia; postanesthesia MAP was very significantly lower in the group C than in the A and B（P〈0.01） ; that was significantly lower in the group A than in the B（P〈0.05）. The postanesthesia HRs were very significantly higher compared with preanesthesia for the 3 groups（P〈0.01） ; those in stimulating were very significantly lower in the group C than in the A and B（P〈0. 01） and there were no significant differences in the other time-point comparisons among the 3 groups（P〈0.05）. Conclusion Propofol used for anaethesia induction in MECT treatment can effectively control such stress reactions as HR quickening caused by stress, BP sudden increase and so on and be served as narcotic drug of first choice.