Comparing the premedication effects of dexmedetomidine, remifentanil and labetalol before electroconvulsive therapy on haemodynamic responses and seizure duration in psychotic patients: A double-blinded clinical trial

Abstract

Objective: The study addressed the comparable effects of premedication with dexmedetomidine (DEX), remifentanil (REM) and labetalol (LAB) before electroconvulsive therapy (ECT) on haemodynamic responses and seizure duration in psychotic patients. Materials and Methods: A double-blinded trial recruited four randomised groups of patients undergoing ECT (N = 144), including 0.5 μg/kg DEX, 0.2 mg/kg LAB, 1 μg/kg REM and 20 ml normal saline, respectively. The mean arterial pressure (MAP), heart rate (HR) and saturated oxygen were recorded every 5 min until the patient was transferred to the department. Besides, the recovery time, seizure duration and satisfaction were recorded. Data were analysed in SPSS software using analysis of variance and repeated measurement tests. Results: The MAP and HR were lower in the DEX (P < 0.001) with the longest recovery time (P < 0.001), while the time was lower in the REM. The DEX group showed shorter seizure duration, lower selected energy (P < 0.001) and the highest satisfaction (P < 0.001). Conclusion: The DEX patients appeared to have the highest satisfaction with the shortest seizure duration, as well as the lowest energy used in ECT, and if appropriate useful psychiatric treatment is provided, this adjuvant can be a great option for patients undergoing the therapy, but this reduces BP/HR while prolonging recovery time.

Keywords

• dexmedetomidine
• electroconvulsive therapy
• haemodynamic responses
• labetalol
• premedication
• remifentanil