Effects of adding dexmedetomidine to ketamine on heart rate and blood pressure changs in psychiatric patients undergoing electroconvulsive therapy

Electroconvulsive therapy (ECT) is used to treat generalized seizures in psychiatric diseases. The aim of this study was to evaluate the effect of adding dexmedetomidine to ketamine on heart rate and blood pressure changes in in psychiatric patients undergoing electroconvulsive therapy (ECT)

In this randomized, double-blind randomized clinical trial, taken place at the Alzahra Subspecialty Medical Center (Isfahan, Iran) between 2018- 2019. Fifty patients who were candidate for undergoing ECT entered the study and were divided into two groups namely A and B. The group A received a package containing 0.5 mg/kg succinylcholine and 1.5 mg/kg ketamine plus 0.1 mg/kg dexmedetomidine, and the group B received a medicine package containing 0.5 mg/kg succinylcholine and 1.5 mg/kg ketamine plus normal saline. The hemodynamic variables and side effects of the two drug classes were evaluated and compared to each other.

The durations of spontaneous respiratory recovery from seizure termination, end seizure to complete consciousness and recovery in the group A was significantly lower than the group B (P<0.001). However, the mean of systolic blood pressure and mean arterial blood pressure after the end of seizure was significantly less in the group A than the group B, but the mean of SPO2 in the fifth minute in the group B was significantly lower than the group A. However, the frequency of nausea and muscle pain in the group B was significantly higher than the group A.

The addition of dexmedetomidine to ketamine in the candidate patients for ECT can shorten the duration of seizure, recovery time, respiratory depression, and also reduce complications such as nausea, muscle pain and oxygen depletion.