Evaluation of the Effect of Dexmedetomidine on Acute Hemodynamic Response in Patients Undergoing Modified Electroconvulsive Therapy

Abstract

Background: Electroconvulsive therapy (ECT) is a well-established and effective treatment for severe psychiatric disorders, but it is associated with significant hemodynamic fluctuations during and after the procedure. These fluctuations include increases in blood pressure and heart rate, which may pose risks, especially in patients with preexisting cardiovascular conditions. Dexmedetomidine, an alpha-2 adrenergic agonist, has been used to manage these hemodynamic changes due to its sedative and sympatholytic effects. This study aims to evaluate the effect of dexmedetomidine on the acute hemodynamic response in patients undergoing modified electroconvulsive therapy (MECT).

Methods: A randomized controlled trial was conducted with 60 patients scheduled for MECT. Patients were randomly assigned to receive either dexmedetomidine or a placebo 10 minutes before the procedure. Hemodynamic parameters, including blood pressure, heart rate, and oxygen saturation, were monitored at baseline, during the procedure, and post-procedure. Data were analyzed to compare the extent of hemodynamic fluctuations between the dexmedetomidine and placebo groups.

Results: Patients who received dexmedetomidine demonstrated significantly reduced increases in systolic blood pressure, diastolic blood pressure, and heart rate during and immediately after the procedure compared to the placebo group. The incidence of hypertension and tachycardia was lower in the dexmedetomidine group.

Conclusion: Dexmedetomidine effectively attenuates the acute hemodynamic response during and after MECT, suggesting it may be a beneficial adjunct in managing cardiovascular stability in patients undergoing ECT.

Keywords: Dexmedetomidine, Electroconvulsive Therapy, Hemodynamic Response, Blood Pressure, Heart Rate, Modified Electroconvulsive Therapy