Outcome of pretreatment regimens on hemodynamic parameters and emergence during electroconvulsive therapy-a study on dexmedetomidine and esmolol

Aim: Present study was performed with an aim to observe the effect on hemodynamic parameters and emergence during electroconvulsive therapy using dexmedetomidine and esmolol as pretreatment regimens. Methodology: In this prospective study, we selected all patients undergoing ECT from January 2017 to February 2018 in our hospital by convenient sampling, and divided them as follows; Group C (Control Group): patients who did not receive any pretreatment. Group D (Dexmedetomidine Group): inj dexmedetomidine 0.5 [micro]g/kg diluted with 10 ml normal saline and administered over 10 min and Group E (Esmolol Group): inj esmolol 1mg/kg diluted in 10 ml normal saline and administered over 2 min during preoxygenation. Pulse rate, systolic, diastolic blood pressure and Sp[O.sub.2] were measured at baseline value and compared after administration of drugs at various intervals. Results: We observed statistically significant reduction in mean heart rate and blood pressure in Group E, followed by Group D after administration of drugs. Highly significant rise in hemodynamic parameters (HR, SBP, DBP) from baseline were observed in Group C at 1, 3 and 5 min after ECT shock and returned to baseline value at 10 min of ECT current. Obeying commands and eye opening were significantly delayed in Group D when compared to Group C and Group E. (p [less than or equal to] 0.05) Conclusion: Attenuation of hemodynamic parameters during ECT are effectively achieved by inj esmolol 1 mg/kg followed by inj dexmedetomidine 0.5 [micro]g/kg, but dexmedetomidine produces delayed recovery and attenuates emergence agitation better than esmolol without affecting seizure duration or any other complications. Key words: Attenuation, Agitation, Dexmedetomidine, Electroconvulsive therapy, Esmolol