Electroconvulsive therapy (ECT) is an effective therapy for psychiatric disorders, but is associated with acute hyperdynamic responses including transient hypertension and tachycardia. This study aimed to assess the effectiveness of premedication with dexmedetomidine for hemodynamic attenuation after ECT and to evaluate its effects on seizure duration, postictal asystole duration, post ECT agitation and recovery time. Twenty-four psychiatric patients who underwent a total of 72 ECT sessions (three sessions per patient) were randomly allocated to receive either dexmedetomidine 0.5 mcg/kg intravenous, dexmedetomidine 1 mcg/kg intravenous, or saline (control group) 15 min before the first ECT session. The patients subsequently received the other two premedication options for their next two ECT sessions. Blood pressure and heart rate were recorded at 5, 10, and 15 min after drug infusion and at 2.5, 5, 7.5, 10, 15, 20, 25, and 30 min after ECT. Asystole duration, seizure duration, post ECT agitation and recovery times were also recorded. The baseline characteristics were similar between the groups. Systolic blood pressure in both dexmedetomidine groups was significantly lower than that in the control group after ECT (p = 0.002). Diastolic blood pressure and heart rate were significantly lower in the dexmedetomidine 1 mcg/kg group (p = 0.002 and p = 0.013, respectively) compared with the control group. Asystole duration, seizure durations, post ECT agitation and recovery times were similar between the groups. Dexmedetomidine 1 mcg/kg administered 15 min before ECT attenuated the hemodynamic response, including suppressing the systolic, diastolic and heart rate increases, during ECT without affecting recovery time. It also did not prolong the post-stimulus asystole duration. TCTR20170715003 , registered at Thai Clinical Trials Registry (TCTR), principal investigator: Pattika Subsoontorn, date of registration: 15/07/2017.

中文翻译：

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右美托咪定预防电休克治疗后高动力反应的术前用药：一项交叉、随机对照试验

电惊厥疗法 (ECT) 是治疗精神疾病的有效疗法，但与包括短暂性高血压和心动过速在内的急性高动力反应有关。本研究旨在评估右美托咪定术前用药对 ECT 后血流动力学衰减的有效性，并评估其对癫痫发作持续时间、发作后心脏停搏持续时间、ECT 后躁动和恢复时间的影响。总共接受了 72 次 ECT 治疗（每名患者 3 次治疗）的 24 名精神病患者被随机分配接受右美托咪定 0.5 mcg/kg 静脉注射、右美托咪定 1 mcg/kg 静脉注射或在第一次治疗前 15 分钟接受生理盐水（对照组） ECT 会议。患者随后在接下来的两次 ECT 疗程中接受了另外两种术前用药选择。在药物输注后 5、10 和 15 分钟以及 ECT 后 2.5、5、7.5、10、15、20、25 和 30 分钟记录血压和心率。还记录了心脏停搏持续时间、癫痫发作持续时间、ECT 后激动和恢复时间。各组之间的基线特征相似。ECT 后两个右美托咪定组的收缩压均显着低于对照组（p = 0.002）。与对照组相比，右美托咪定 1 mcg/kg 组的舒张压和心率显着降低（分别为 p = 0.002 和 p = 0.013）。各组之间的心脏停搏持续时间、癫痫发作持续时间、ECT 后激动和恢复时间相似。ECT 前 15 分钟给予右美托咪定 1 mcg/kg 可减弱血流动力学反应，包括抑制收缩压，ECT 期间舒张压和心率增加而不影响恢复时间。它也没有延长刺激后心脏停搏持续时间。TCTR20170715003，在泰国临床试验注册中心（TCTR）注册，首席研究员：Pattika Subsoontorn，注册日期：15/07/2017。