依托咪酯、丙泊酚混用和单用在无抽搐电休克中的随机对照研究

A randomized controlled study of the mixed- or single-application of etomidate and propofol during modified electroconvulsive therapy(MECT)

目的:研究依托咪酯丙泊酚混用和单用在无抽搐电休克(MECT)治疗的可行性。方法:90例行MECT治疗的患者随机分成3组,分别应用依托咪酯-丙泊酚混合液(E-P组)、依托咪酯(E组)、丙泊酚(P组)麻醉,记录3组治疗中输入电量(CD)、运动发作时间(ESD)、抑制指数(PSI)、抽搐能量指数(SEI)、抽搐一致性指数(SGI),治疗前后以阳性与阴性症状量表(PANSS)和韦氏记忆量表(WMS)评定其精神状况及记忆水平,记录出现的不良反应,所有数据用SPSS 12.0处理。结果:治疗后E-P组ESD、PSI、SEI、SGI、WMS评分、PANSS减分均高于P组(P<0.05),CD显著低于P组(P<0.05),与E组相当(P>0.05);不良反应方面:恶心呕吐、分泌物增多E-P组低于E组(P<0.05),注射疼E-P组低于P组(P<0.05)。结论:依托咪酯-丙泊酚混合液应用于MECT麻醉优于两种药物的单独应用。

Objective To explore the feasibility of the mixed- or single-application of etomidate and propofol during modified electroconvulsive therapy （MECT）. Methods Ninety hospitalized schizophrenics undergoing MECT were randomly assigned to 3 groups which were respectively anesthetized with mixed liquor application of etomidate and propofol （group E-P）, etomidate （E） or propofol （P）. Charge delivered （CD）, EEG seizure duration （ESD）, postictal suppression index （PSI）, seizure energy index （SEI） and seizure generalization index （SGI） were recorded. Mental status and memory levels were assessed with the Positive and Negative Syndrome Scale （PANSS） and Wechsler Memory Scale （WMS） before and after treatment. The adverse reactions were recorded. All data were analyzed with the software SPSS12.0. Results The ESD, PSI, SEI, SGI and WMS scores, and the minus score of PANSS were significantly higher （P 〈 0.05） and CD was lower （P 〈 0.05） in group E-P than those in group P. No significant alteration between group E-P and group E （P 〉 0.05）. The adverse reactions such as nausea/vomiting and secretion increase in group E-P were lower than those in group E （P 〈 0.05）. The injection pain of group E-P was lower than that of group P （P 〈 0.05）. Conclusion The mixed liquor of etomidate and propofol has an advantage over the single-application of the two drugs during MECT.