■电惊厥疗法(ECT)是一种广泛使用的治疗严重精神疾病,如精神分裂症,抑郁症,和躁狂症。该程序包括施加短暂的电刺激以诱发癫痫发作,麻醉用于确保镇静和肌肉放松。找到副作用最小的正确麻醉剂,特别是在癫痫发作持续时间上,对于最佳结果至关重要,因为癫痫发作持续时间是ECT有效性的重要因素,但是使用的麻醉剂会影响它。
■本系统综述和荟萃分析旨在汇集比较两种诱导剂的所有相关研究的结果,依托咪酯和异丙酚,运动和脑电图(EEG)癫痫发作持续时间的结果。
■在PubMed上进行了全面的文献检索,Medline,和Cochrane图书馆数据库来识别相关文章。主要结果指标是运动和脑电图癫痫发作持续时间。通过执行异质性来确保统计能力,出版偏见,敏感性分析,和亚组分析。计算连续结局的标准平均差和95%置信区间,并使用随机效应模型。
■本荟萃分析共纳入16项研究,包括7项随机对照试验(RCT),7个交叉试验,和2个队列。与异丙酚相比,依托咪酯的总体运动性癫痫发作持续时间在统计学上明显更长。与异丙酚相比,使用依托咪酯的EEG癫痫发作持续时间的总体结果也更长,并且具有统计学意义。此外,根据两个结局的研究设计进行分组,在这两个结果的队列亚组中显示出微不足道的结果,而RCT和交叉亚组支持总体结果。通过分组和敏感性分析评估异质性。
■我们的荟萃分析发现,在ECT中,依托咪酯在运动和脑电图发作持续时间方面优于异丙酚,暗示潜在的更好的疗效。因此,依托咪酯应被视为ECT的首选诱导剂,但需要更大的研究来进一步验证我们的发现.
UNASSIGNED: Electroconvulsive therapy (ECT) is a widely used treatment for severe psychiatric disorders such as schizophrenia, depression, and mania. The procedure involves applying brief electrical stimulation to induce a seizure, and anesthesia is used to ensure sedation and muscle relaxation. Finding the right anesthetic agent with minimal side effects, especially on seizure duration, is crucial for optimal outcomes because seizure duration is an important factor in the effectiveness of ECT, but the anesthetic agents used can affect it.
UNASSIGNED: This systematic review and meta-analysis aimed to pool the results of all relevant studies comparing the two induction agents, etomidate and propofol, for motor and electroencephalogram (EEG) seizure duration outcomes.
UNASSIGNED: A comprehensive literature search was conducted in the PubMed, Medline, and Cochrane Library databases to identify the relevant articles. The primary outcome measures were motor and EEG seizure durations. Statistical power was ensured by performing heterogeneity, publication bias, sensitivity analysis, and subgroup analysis. Standard mean difference and 95% confidence intervals were calculated for continuous outcomes, and a random-effects model was used.
UNASSIGNED: A total of 16 studies were included in this meta-analysis, comprising 7 randomized control trials (RCTs), 7 crossover trials, and 2 cohorts. The overall motor seizure duration was statistically significantly longer with etomidate than with propofol. The overall result for EEG seizure duration was also longer with the use of etomidate over propofol and was statistically significant. In addition, subgrouping was performed based on the study design for both outcomes, which showed insignificant results in the cohort\'s subgroup for both outcomes, while the RCTs and crossover subgroups supported the overall results. Heterogeneity was assessed through subgrouping and sensitivity analysis.
UNASSIGNED: Our meta-analysis found that etomidate is superior to propofol in terms of motor and EEG seizure duration in ECT, implying potentially better efficacy. Hence, etomidate should be considered the preferred induction agent in ECT, but larger studies are needed to further validate our findings.