Dexmedetomidine in premedication to attenuate the acute hyperdynamic response to ECT: a randomised, double-blind, controlled study

Abstract

Background: The choice of anaesthetic agent for electroconvulsive therapy (ECT) depends on seizure duration, haemodynamic and recovery parameters. The aim of the study was to assess the effects of dexmedetomidine premedication on haemodynamic, seizure duration, recovery characteristics and agitation following ECT.
Material and method: 60 patients aged 18–60 years scheduled for ECT were enrolled in the study. Dexmedetomidine (0.5 μg/kg) diluted to 10 ml with 0.9% saline or 10 ml 0.9% saline (control) were infused intravenously over 10 min before induction of anaesthesia with thiopentone. Motor seizure duration, heart rate, mean arterial blood pressure, time to spontaneous respiration, obeying verbal commands and post-ECT agitation score were recorded. Statistical analysis was carried out using MS Excel and Primer of Biostatistics.
Results: Post-ECT rise in mean arterial blood pressure (MAP) and heart rate (HR) in the dexmedetomidine group was significantly less (p < 0.001) compared with the control group at 1, 3, and 5 mins. Motor seizure duration was comparable in both groups. Mean agitation score was significantly low in the dexmedetomidine group (1.5 ± 0.50) compared with the control group (1.93 ± 0.52).
Conclusion: A dexmedetomidine dose of 0.5 μg/kg IV administered over 10 min before the induction of anaesthesia may be useful in preventing the acute hyperdynamic responses to ECT and post-ECT agitation without altering the duration of seizure activity and recovery time.