Cengiz Bekir DEMİREL, İsmail KATI, HASAN KOÇOĞLU, Ürfettin Abbasov HÜSEYİNOĞLU, EMİN SİLAY

Elektrokonvülsif tedavide propofol ile propofol+alfentanil'in konvülsiyon süresi, hemodinamik yanıtlar ve derlenme üzerine etkileri

Bu çalışmanın amacı, elektrokonvülsif tedavide (EKT) propofol ile propofol-alfentanil kombinasyonunun konvülsiyon süresi, hemodinamik yanıtlar ve derlenme üzerine etkilerinin araştırılmasıdır. Olgular EKT uygulaması sırasında arteriyal kan basıncı, kalp atım hızı, periferik oksijen satürasyonu ve elektrokardiyografi ile monitörize edildi. Hastalar rastgele iki gruba ayrıldı (Grup l: propofol, n:16, Grup II: propofol+alfentanil, n:16). Atropin ile premedikasyon sağlandıktan sonra Grup I 'e propofol 0.75 mg kg-1, Grup II'ye propofol 0.50 mg kg-1 ve alfentanil 20 $mu$g kg-1 verildi. Gerekli görülen olgulara bilinç kaybı oluşuncaya kadar propofol 0.1 mg kg-1 ilave dozlar halinde verildi. Kas gevşemesi için süksinilkolin 1.0 mg kg-1 kullanıldı. Fasikülasyonların kaybolmasından hemen sonra elektrik uyarısı verildi. Ortalama motor konvülsiyon süresi propofol-alfentanil grubunda propofol grubuna göre daha uzun bulundu. Hemodinamik yanıtlar ve derlenme özellikleri iki grupta da benzer şekildeydi. Sonuç olarak, EKT uygulamalarında propofol alfentanil kombinasyonunun daha iyi bir seçenek olduğu kanısına varıldı.

Anahtar Kelimeler:

Elektrokonvülsif tedavi, İlaç kombinasyonları, Alfentanil, Propofol

The effects of propofol and propofol-alfentail used in electroconvulsive therapy on duration of convulsion, hemodynamic responses and recovery characteristics

The aim of this study was to investigate the effects of propofol and propofol-alfentanil combination used in Electroconvulsive therapy (ECT) on duration of convulsion, hemodynamic responses cardiovascular system and recovery characteristics. Arterial blood pressure, heart rate, peripheral oxygen saturation, and electrocardiogram were monitored during the ECT procedure. Patients were randomized into two groups (Group I: propofol, n:16, Group II: propofol+alfentanil, n:16). After premedication with atropine, the G I received propofol 0.75 mg kg-1 and the G II received propofol 0.50 mg kg-1 and alfentanil 20$mu$g kg-1 Additional propofol was given as needed in 0.1 mg kg-1 increments until loss of consciousness. Suxamethonium 1.0 mg kg-1 IV was given for muscular paralysis. The electrical stimulus was administered immediately after resolution of fasciculations. Mean motor convulsion duration were longer with propofol-alfentanil than with propofol. Hemodynamic responses and recovery characteristics were similar for the two groups. We concluded that the combination of propofol with alfentanil is a better combination for ECT.

Keywords:

Electroconvulsive Therapy, Drug Combinations, Alfentanil, Propofol,

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