依托咪酯联合丙泊酚用于老年精神疾病患者行无抽搐电休克治疗的安全性分析

目的:探讨依托咪酯联合丙泊酚用于老年精神疾病患者行无抽搐电休克治疗的安全性。方法:选取我院准备进行无抽搐电休克治疗的≥60岁的老年精神疾病患者96例,随机分为依托咪酯组、丙泊酚组和依托咪酯联合丙泊酚组,每组32例。丙泊酚组予以2 mg/kg丙泊酚静注后给予改良电抽搐疗法(MECT)治疗,依托咪酯组予以0.3 mg/kg依托咪酯静注后给予改良电抽搐疗法(MECT)治疗,依托咪酯联合丙泊酚组予以依托咪酯(0.15 mg/kg)和静注丙泊酚(1 mg/kg)后予以改良电抽搐疗法(MECT)治疗。分别于麻醉诱导前、诱导中、电刺激即刻、电刺激后5分钟、10分钟检测患者的心率及血压指标。结果:与麻醉诱导前相比,三组患者麻醉诱导后HR、SBP、DBP均下降(P0.05),电刺激即刻HR、SBP、DBP均明显升高(P0.05);与电刺激即刻相比,三组患者电刺激后5 min HR、SBP、DBP显著下降(P0.05);与丙泊酚组及依托咪酯组相比,依托咪酯联合丙泊酚组麻醉诱导后HR较低,电刺激即刻HR、SBP、DBP水平较低(P0.05)。托咪酯联合丙泊酚组不良反应发生率低于依托咪酯组、丙泊酚组(P0.05)。结论:依托咪酯联合丙泊酚组在老年精神障碍患者进行无抽搐电休克治疗时的安全性较单用依托咪酯组或丙泊酚更高。

Analysis of the Safety of Etomidate combined with Propofol in the Treatment of Senile Schizophrenia Patients with Electroconvulsive Shock

ABSTRACT Objective: To investigate the safety of etomidate combined with propofol in the treatment of senile schizophrenia pa- tients with electroconvulsive shock. Methods: 64 senile patients with schizophrenia who were treated in the psychiatric department of our hospital were selected and randomly divided into the etomidate group, t propofol group and combination group, with 32 cases in each group. The patients in the etomidate group were treated with 0.3 mg/kg etomidate and modified electric convulsive therapy (MECT), the patients in the propofol group group were treated with 2 mg/kg propofol intravenous injection and modified electric convulsive therapy (MECT), and the patients in the combination group were treated with 0.15 mg/kg etomidate and 1 mg/kg propofol and modified electric convulsive therapy (MECT). Then the heart rate and blood pressure of patients at five minutes and ten minutes after the treatment were detected and compared. Results: Compared with before induction of anesthesia, the HR, SBP and DBP decreased in the three groups after anesthesia induction, and the HR, SBP and DBP increased in the electrical stimulation immediately time (P<0.05); Compared with elec- trical stimulation time, the HR DBP and SBP decreased after electrical stimulation for 5 mins (P<0.05); Compared with propofol group and etomidate group, the HR, HR and SBP in the combination group were lower after induction of anesthesia, and the DBP was lower in electrical stimulation time (P<0.05); The incidence of adverse reactions in the combination group was lower than those of the propofol group and the etomidate group (P<0.05). Conclusion: The safety of etomidate combined with propofol in senile patients with mental dis- orders electroconvulsive therapy was higher compared with etomidate or propofol alone.