Comparison of Pretreatment with Dexmedetomidine and Metoprolol on Attenuation of Hemodynamic Parameters and Emergence During Electroconvulsive Therapy

Objective: To evaluate the effects of Dexmedetomidine and Metoprolol as a pretreatment regimen on hemodynamic parameters and emergence during ECT. Study Design: Randomized controlled trial (ANZCTR Trial Id: ACTRN12623000539639) Place and Duration of Study: Department of Anesthesia, CMH, Sialkot, Pakistan, from January 2021 to April 2022. Methodology: All patients undergoing ECT at CMH were enrolled in this prospective study using a convenient sampling method and divided into three groups. The C Group included subjects not pretreated with any medication. Group-D received an injection of Dexmedetomidine 0.5 μg/kg diluted in 10 mL NaCl, infused intravenously over 10 minutes. Group-M received an injection of Metoprolol 1 mg diluted in 10 mL NaCl, infused over 2 minutes during preoxygenation. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded at baseline, then documented after drug administration at various time intervals Results: This study performed statistical comparisons of heart rate, blood pressure, and post-procedure recovery parameters among three groups (Group-C, Group-D, and Group-M). Significant differences were found in heart rate, with Group-D and Group-M displaying significantly lower heart rates than Group-C at various time points after the intervention (p<0.001). Additionally, Group-D had significantly higher systolic blood pressure than both Group-C and Group-M after the intervention (p<0.001). Conversely, Group-M showed significantly lower diastolic blood pressure compared to Group-C and Group-D (p<0.05). Conclusion: Metoprolol at a dose of 1 mg or Dexmedetomidine administered intravenously at a dose of 0.5 µg/kg are both effective methods for attenuating hemodynamic parameters during ECT. .....