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Background & objectives: Electroconvulsive therapy (ECT) is the main therapeutic technique in psychiatric diseases. The use of anesthesia for ECT is necessary. In these patients, selection of anesthesia with minimal hemodynamic changes is very important. The aim of this study was to compare the hemodynamic effects of two anesthetics including sodium thiopental and propofol in patients undergoing ECT.
Methods: This study was performed on 84 patients (50 males and 34 females) who were anesthetized for ECT in 22- Bahaman Hospital, Qazvin University of Medical Sciences (QUMS). Initially, the hemodynamic status of patients was recorded. Then, they randomly received either sodium thiopental or propofol as an anesthetic and succinylcholine as a muscle relaxant. Hemodynamic changes, including systolic and diastolic blood pressure, pulse rate in the 1, 3 and 10 minutes after ECT, as well as seizure duration and recovery time were recorded. The data were analyzed by SPSS v.20 using independent t-test.
Results: the sodium thiopental group, showed the highest changes in systolic and diastolic blood pressure and heart rate in the third minute (45%, 64% and 26% respectively). In the propofol group, the highest systolic, diastolic and mean arterial blood pressure changes were 55%, 64% and 43% respectively, at the 10th minute, but the highest pulse rate (33%) occurred in the 3rd minute. The blood pressure changes were significant between the two groups (p<0.05). The post-shock seizure duration was less with sodium thiopental, but recovery from anesthesia was shorter with propofol (p<0.05).
Conclusion: Our findings showed that in the anesthetic required for electroshock, sodium thiopental had a slightly better hemodynamic stability than propofol. Therefore, it seems appropriate to use it as an anesthetic for ECT.
 

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Background & objectives: The use of controlled hypotension is important to reduce bleeding in some surgeries. This study aimed to determine the effects of dexmedetomidine (DEX) and labetalol for induced hypotension in maxillofacial fractures surgery.
Methods: In this triple-blind randomized controlled clinical trial study, the patients with maxillofacial fractures were randomly divided into two groups: group 1. Dexmedetomidine (DEX) (bolus dose: 1μg/kg and maintenance dose: 0.3-0.5 μg/kg/h) and group 2. Labetalol (bolus dose: 0.3mg/kg and maintenance dose: 0.2-0.5 mg/kg/h). The patient's hemodynamic indices (including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at various surgical intervals. Finally, the surgeon's satisfaction (from 1-6 points) was evaluated. Data were analyzed using SPSS 19 software.
Results: The MAP, SBP, and DBP were significantly higher in the DEX group than the Labetalol group especially at 30 and 90 minutes after the bolus. The mean HR was significantly lower in the DEX group than Labetalol during the recovery period. The surgeon's satisfaction in the Labetalol group was significantly higher than the DEX group.
Conclusion: Based on the results, labetalol offers a better hemodynamics conditions than DEX during surgery and also lead to greater overall surgeon satisfaction.