ETOMIDATE VERSUS COMBINATION OF ETOMIDATE WITH DEXMEDETOMIDINE FOR MOTOR SEIZURE DURATION AND ATTENUATION OF HYPERDYNAMIC RESPONSES TO MODIFIED ECT

Abstract

Introduction: Electroconvulsive therapy (ECT) is a crucial treatment for psychiatric disorders, but concerns about adverse effects have led to research on optimizing anesthesia regimens. This study investigates the efficacy of etomidate alone versus a combination of etomidate and dexmedetomidine in reducing motor seizure duration and mitigating hyperdynamic responses during ECT procedures. Aims: The study explores the impact of dexmedetomidine premedication on hyperdynamic responses to modified ECT, seizure duration, and recovery time, aiming to determine its effectiveness. Methodology: A prospective, randomized clinical trial at Krishna Institute of Medical Sciences in Maharashtra involved 60 adult patients who underwent modified ECT over 22 months. The study included 30 patients in Group A and 30 in Group B, with etomidate alone or dexmedetomidine premedication as induction agents. Patients were assessed for side effects and discharged post-anesthetic. Results: The study compares patients' age, sex, body weight, heart rates, and adverse effects of etomidate alone and etomidate plus dexmedetomidine, finding similar percentages but no significant reduction in rescue analgesia need. Discussion: The study reveals a balanced demographic in anesthesia protocols, with males dominating ED and females dominating etomidate-only groups. Combining etomidate and dexmedetomidine reduces adverse effects and enhances patient safety. Conclusion: The study found that combining dexmedetomidine with etomidate reduces hyperdynamic response to electroconvulsive therapy without affecting anaesthesia recovery, with lesser nausea, vomiting, and shivering.