title: Dexmedetomidine Combined With Intravenous Anesthetics in Electroconvulsive Therapy: A Meta-analysis and Systematic Review.
abstract: OBJECTIVE
  The aim of this study was to investigate how the combined use of dexmedetomidine with intravenous anesthetics influences seizure duration and circulatory dynamics in electroconvulsive therapy (ECT).
  
  
  METHODS
  A literature search was performed to identify studies that evaluated the effect of dexmedetomidine on motor- or electroencephalogram (EEG)-based seizure durations and maximum mean arterial pressure (MAP) and heart rate (HR) after ECT. Moreover, recovery time and post-ECT agitation were evaluated.
  
  
  RESULTS
  Six studies enrolling 166 patients in 706 ECT sessions were included. There was no significant difference in motor or EEG seizure duration between dexmedetomidine and nondexmedetomidine groups [motor: 6 studies; mean difference (MD), 1.62; 95% confidence interval (CI), -2.24 to 5.49; P = 0.41; EEG: 3 studies; MD, 2.34; 95% CI, -6.03 to 10.71; P = 0.58]. Both maximum MAP and HR after ECT were significantly reduced in the dexmedetomidine group (MAP: 6 studies; MD, -4.83; 95% CI, -8.43 to -1.22; P = 0.009; HR: 6 studies; MD, -6.68; 95% CI, -10.74 to -2.62; P = 0.001). Moreover, the addition of dexmedetomidine did not significantly prolong recovery time when the reduced-dose propofol was used (4 studies; MD, 63.27; 95% CI, -15.41 to 141.96; P = 0.12).
  
  
  CONCLUSIONS
  The use of dexmedetomidine in ECT did not interfere with motor and EEG seizure durations but could reduce maximum MAP and HR after ECT. Besides, the addition of dexmedetomidine in ECT did not prolong recovery time when reduced-dose propofol was used. It might be worthwhile for patients to receive dexmedetomidine before the induction of anesthesia in ECT.
authors.affiliation: From the Departments of *Anesthesiology, and †Psychiatry, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Fang
authors.initials: F
authors.lastname: Tan
authors.forename: Nan
authors.initials: N
authors.lastname: Cheng
authors.forename: Na
authors.initials: N
authors.lastname: Guo
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Zhong
authors.forename: Zi-Qing
authors.initials: ZQ
authors.lastname: Hei
authors.forename: Qian-Qian
authors.initials: QQ
authors.lastname: Zhu
authors.forename: Shao-Li
authors.initials: SL
authors.lastname: Zhou
mesh_terms: D000758:Anesthesia / Q000379:methods*; D000777:Anesthetics; D020927:Dexmedetomidine; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives; D012640:Seizures
chemical_list: D000777:Anesthetics; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine