Ayşe Zeynep TURAN, MEHMET YILMAZ, Vildan KILIÇ YILMAZ, Aslı Duygu AYDAŞ, Öyküm FINDIK

The Effect Of Lidocaine On The Effıciency Of Electroconvulsive Therapy

INTRODUCTION: Electroconvulsive therapy is the most important therapeutic modality used in psychiatric disorders. The efficiency of the therapy is related to the duration of a seizure. Propofol is frequently chosen anesthetic agent for ECT anesthesia. Intravenous lidocaine is frequently used as an adjuvant agent during propofol induction. Anesthetic agents and also adjuvant agents as lidocaine used for sedation during ECT should not affect duration and quality of the seizure. In this study, we aimed to investigate the effect of lidocaine during electroconvulsive therapy on the length of seizures. METHODS: Current study designed prospectively randomized controlled double blind trial. Patients were randomly assigned into two groups: Group P (propofol, n=39) or Group PL (propofol-lidocaine, n=41) by sealed envelop method. Patients in Group P were given 5 ml (5 ml SF), patients in Group PL were given 5 ml (2 ml of 2% lidocaine + 3 ml SF) by the researcher, and then propofol induction was performed. All patients in Group P and Group PL were given 1mk/kg of succinylcholine to prevent muscle relaxation when the BIS value was 60. RESULTS: There was no statistically significant difference between two groups in terms of Demographic information, propofol amounts and bispectral index values (p>0,05). The incidence of cardiac arrhythmia was statistically significantly lower in Group PL than Group P (p=0.036). Duration of seizure was significantly higher in Group PL compared to Group P (p

Lidokainin Elektrokonvulzif Tedavi Etkinliği Üzerine Etkisi

GİRİŞ ve AMAÇ: Elektrokonvülzif tedavi psikiyatrik bozuklukların tedavisinde kullanılan en önemli tedavilerden biridir. Tedavinin etkinliği nöbet süresi ile ilişkilidir. Propofol EKT uygulamalarında sıklıkla tercih edilen anestezik ajandır. Propofol indüksiyonu yapılan hastaslarda lidokain de adjuvan ajan olarak kullanılmaktadır. EKT için kullanılan anestezik ajanların ve lidokain gibi adjuvan ilaçların da nöbet süresini ve kalitesini etkilememelidir. Bu çalışmada EKT sırasında kullanılan lidokainin nöbet süresi üzerine etkinliğini araştırmayı amaçladık. YÖNTEM ve GEREÇLER: Bu çalışma randomize kontrollü çift kör olarak dizaynedildi. Hastalar kapalı zarf yöntemiyle randomize edilerek iki gruba ayrıldı; grup P (propofol n=39) ve grup PL (Propofol-lidocaine n=41 ). P grubundaki hastalara 5 ml SF ve PL grubundaki hastalara 2 ml %2 lidokain+3 ml SF verilmesini takiben propofol indüksiyonu yapıldı. Tüm hastalara bispektral indeks (BIS) değeri 60 olduğunda kas gevşetici olarak 1 ml/kg dozunda süksinilkolin uygulandı. BULGULAR: Demografik veriler açısından iki grup arasında anlamlı istatistiksel bir fark bulunamadı (p>0,05). Toplam propofol dozu ve BIS değerleri açısından anlamlı fark bulunamadı (p>0,05). PL grubunda kardiyak aritmi insidansı P grubuna göre anlamlı olarak düşük bulundu (p>0,036). Nöbet süresi ise PL grubunda anlamlı derecede yüksek bulundu (p>0,05). TARTIŞMA ve SONUÇ: EKT sırasında adjuvan ajan olarak uygulanan lidokainin nöbet süresini arttırdığı ve tedavi üzerine pozitif etkinliği olduğu kanaatindeyiz. Ek olarak lidokainin EKT sırasında görülen kardiyovasküler istenmeyen etkileri azalttığını düşünüyoruz.

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