【罂粟摘要】异丙酚联合不同剂量艾司氯胺酮电休克(ECT)治疗抑郁症的效果比较:随机对照试验方案

文摘   2024-11-28 07:00   贵州  

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异丙酚联合不同剂量艾氯胺酮电休克(ECT治疗抑郁症的效果比较:随机对照试验方案


贵州医科大学  麻醉与心脏电生理课题组

翻译:王璐  编辑:王婷婷  审校:曹莹

背景:重度抑郁症(MDD)是一种常见的情绪障碍。电休克疗法 (ECT) 对难治性 MDD 有着显著疗效。艾司氯胺酮可能在提高ECT 疗效方面具有潜在优势,并且该药与 NMDAR 的强亲和力使其成为治疗抑郁症的可行性治疗方案。本研究旨在比较不同剂量的艾氯胺酮联合丙泊酚麻醉与单独使用丙泊酚麻醉在ECT中的效果,旨在为优化ECT和提高抑郁症的综合治疗效果提供进一步的见解。

研究设计和方法:本研究是一项涉及受试者和评估者的前瞻性、随机、对照、双盲试验。计划接受 ECT 的 111 名患者被随机分为三组。P组静脉注射异丙酚1mg/kg。P+E组静脉注射丙泊酚0.5mg/kg、艾氯胺酮0.5mg/kg。P+SE组患者接受0.75mg/kg剂量的丙泊酚和0.25mg/kg剂量的艾氯胺酮。对同一患者使用相同的麻醉方案,直到最后一次治疗结束。主要指标是汉密尔顿抑郁量表 (HAMD) 和患者健康问卷9 (PHQ-9)、哥伦比亚自杀严重程度评定量表 (C-SSRS) 和数字符号替换测试 (DSST)。次要指标包括住院时间、再入院率、血流动力学状态、康复和不良事件。



结论:本研究旨在比较异丙酚联合不同剂量艾司氯胺酮电休克治疗抑郁症的效果。该结果可能为电休克治疗麻醉提供更好的选择。

原始文献来源:Chen X,Zhou R,Lan L, et al. Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol. Neuropsychiatr Dis Treat. 
2024;20:1107-1115. doi:10.2147/NDT.S463028


Comparison of Effects of Propofol Combined with  Different Doses of Esketamine for ECT in the  Treatment of Depression: A Randomized  Controlled Trial Protocol


Objective: Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing comprehensive treatment outcomes for depression.
Study Design and Methods: This study was a prospective, randomized, controlled, double-blind trial involving subjects and evaluators. One hundred eleven patients scheduled for ECT were randomly assigned to three groups. In Group P, propofol at 1mg/kg was administered intravenously. In Group P+E, propofol at a dosage of 0.5mg/kg and esketamine at a dosage of 0.5mg/kg was administered intravenously. Patients in Group P+SE received propofol at a dosage of 0.75mg/kg and esketamine at a dosage of 0.25mg/kg. The same anesthesia protocol was used for the same patient until the end of the last treatment. The primary outcome measures were the Hamilton depression scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9), the Columbia-Suicide Severity Rating Scale (C-SSRS), and the Digit symbol substitution test (DSST). Secondary outcomes included length of hospital stay, readmission rate, hemodynamic status, recovery, and adverse events.
Discussion: This study aimed to compare the effects of propofol combined with different doses of esketamine for ECT. The results may provide a better choice for ECT anesthesia.
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