丙泊酚与依托咪酯在无抽搐电休克治疗中的对比研究

摘要

Objective To observe the effect of propofol and etomidate on seizure duration and energy index in the modified electroconvulsive therapy(ECT). Methods 25 inpatients with mental disorders were randomised to use propofol (P group, 1. 2-1. 5 mg · kg-1) or etomidate (E group, 0. 2-0. 25 mg · kg-1 , another agent was then used in the next time. The heart rate (HR) , blood pressure (BP), ECG seizure duration, energy index, the time of respiratory recovery and consciousness recovery, and adverse events were compared throughout the study. Results The seizure durations in patients of E group were longer than those in the P group. There were no significant differences between P and E group in respond to the HR, BP. The patients in E group seem to have more adverse events than those in P group. Conclusion The patients who received propofol could not get adequate seizure duration in MECT, etomidate could be an altermative induction agent.%目的 观察丙泊酚和依托咪酯在无抽搐电休克治疗(MEG)中对发作时间和抽搐能量指数的影响.方法 25例精神病患者,采用自身前后对照研究,在电休克治疗中随机使用丙泊酚1.2～1.5 mg/kg或依托咪酯0.2～0.25mg/kg麻醉,下一次治疗使用另一种药物,比较两次治疗中患者心率、血压、脑电型癫痫发作时间、抽搐能量指数,患者呼吸恢复时间和意识恢复时间,治疗过程中的不良反应.结果 丙泊酚组脑电型癫痫发作时间明显短于依托咪酯组(P＜0.05),依托咪酯组的不良反应多于丙泊酚组.结论 MECT的患者使用丙泊酚麻醉,发作时间短于治疗所需时,可以使用依托咪酯麻醉.