Effects Of Dexmedetomidine On Succinylcholine-induced Muscle Fasciculation And Postoperative Myalgia After Modified Electric Convulsive Therapy

Objective:To explore the effects of different doses of dexmedetomidine(DEX) on succinylcholine-induced muscle fasciculation and postoperative myalgia after modified electric convulsive therapy(MECT).Methods:This study initially considered a total of ninty patients who were received MECT between May and September 2015.There were 39 men and 51 women and all of them belonging to ASA physical status I–II.The patients were randomly divided into 3groups:high dose DEX group(group D1), low dose DEX group(group D2) and control group(group C)(n=30 in each group).The patients were continuously infused intravenously with 0.6μg/kg DEX in group D1 and 0.2μg/kg DEX in group D2 via an intravenous infusion pump for 10 min before anesthesia.The group C received a placebo infusion of equal volume(20ml) normal saline.The blood pressure,breathing rate,electrocardiogram and peripheral capillary oxygen saturation were monitored.The onset time of seizure,seizure energy index(SEI), autonomous respiration recovery time,awakeness time were recorded.Besides,the dosages of propofol and the degree of muscle fasciculation were recorded after succinylcholine injection.Visual analogue scale(VAS) was used to assess postoperative myalgia at 0.5h(T1), 2h(T2), 6h(T3) after MECT.When patients woke up,we recorded the incidences of adverse reactions.Results:The onset time of seizure,autonomous respiration recovery time and awakeness time were comparable of both groups(P>0.05).The index of SEI was higher in group D1 than group D2 and group C,the dosage of propofol was lower in group D1(P<0.05).Compared with group C,the degree of muscle fasciculation in group D1 and group D2 were decreased significantly;while more patients in group D2 had moderate to severe fasciculation’s compared to group D1(P<0.05).There were no significant difference in VAS scores at T1 among three groups(P>0.05).The VAS scores in group D1 were lower than that in group D2 at T2 and T3,and the scores in group D1 and group D2 were both lower than that in group C(P<0.05).The VAS scores at T2 and T3 were significantly higher than that at T1 in group D2 and group C(P<0.05),while the scores were not different in group D1 at T1,T2 and T3(P>0.05). Complications such as nausea/vomiting,dysphoria and drowsiness were recorded,but we did not find any significant difference among groups(P>0.05).Conclusion:DEX can decrease succinylcholine-induced muscle fasciculation and postoperative myalgia after MECT without influenting curative effect, the dose of 0.6μg/kg is more effectively.