Comparing the effects of Premedication with Dexmedetomidine, Remifentanil, and Labetalol before Electroconvulsive Therapy on Hemodynamic Responses and Seizure Duration in Psychotic Patients

The study addressed the comparable effects of premedication with dexmedetomidine, remifentanil and labetalol before electroconvulsive therapy (ECT) on hemodynamic responses and seizure duration in psychotic patients.

A double-blinded trial recruited four randomized groups of patients undergoing ECT (N=144): the DEX, LAB, REM, and NS, receiving 0.5 μg/kg dexmedetomidine and 0.2 mg/kg labetalol, 1 μg/kg remifentanil, and 20 ml normal saline, respectively, whose mean arterial pressure (MAP), HR, and SPO2 were recorded every 5 minutes until the patient was transferred to the department. Besides, the recovery time, seizure duration, and satisfaction were recorded, afterward followed by SPSS [20] data analysis .

BP/HR were lower in the DEX (p=0.0001) with the longest recovery time (p=0.0001), while the time was lower in the REM. The first group showed shorter seizure duration, lower selected

   Dexmedetomidine   with   high   patient   satisfaction   and   no   need   for   hemodynamic   abnormalities requiring treatment can be a viable option in patients undergoing electroconvulsive therapy, although  it  may  slightly  increase  recovery  time,  and  remifentanil  is  also  a  good  option  for  induction  of  ECT.  Patients'  satisfaction  with  it  is  second  only  to  dexmedetomidine,  and  our  study  did  not  produce  a  hemodynamic  disorder  requiring  treatment.  Therefore,  we  believe  that  either  of  these  drugs  may  be  a  good option for use in ECT, depending on the diagnosis of the anesthesiologist.energy (p=0.0001), and the highest satisfaction (p=0.0001)