Effectiveness of Dexmedetomidine as premedication to modify the heart rate response to modified electroconvulsive therapy: a randomized controlled trial

Background: The present study aims to examine whether using Dexmedetomidine as a premedication can reduce heart rate (HR) and peak HR during modified electroconvulsive therapy (ECT). It is known that the acute hemodynamic stress induced by ECT may elevate the risk of cardiovascular complications in psychiatric patients. Previous research has suggested that β-blockers and α-2 adrenergic agonists effectively alleviate the hyperdynamic responses to ECT. Therefore, the current study seeks to determine whether Dexmedetomidine can offer similar benefits in regulating HR fluctuations during the modified ECT procedure. Materials and Methods: In this prospective, double-blinded, randomized controlled study, a total of 60 psychiatric patients aged between 18 and 50 years, categorized as per the American Society of Anaesthesiologists score I and II, and scheduled for ECT, were included. These patients were randomly divided into two groups: Group D, which received 50 mL of normal saline (NS) with 1 µg/kg of Dexmedetomidine, and Group C, which received 50 mL of NS only. HR measurements were taken every 15 s for 5 min following the modified ECT, and any changes in peak HR were carefully recorded and analyzed. Results: The mean age (years) and weight (kg) in groups C and D were 29.5 ± 7.82 and 32.5 ± 8.37, 59.4 ± 5.33 and 58.6 ± 4.57, respectively. Both groups did not differ significantly concerning age (P = 0.157) and weight (P = 0.519). Statistically, no significant difference in mean HR (baseline, before ECT, and peak HR following ECT within 5 min) was observed between study groups. In group D, the rise in HR was significantly less when compared to group C (P = 0.001). The groups had a significant (P = 0.001) difference in HR before ECT. Conclusions: The administration of Dexmedetomidine at a dose of 1 µg/kg as premedication resulted in a notable decrease in HR and peak HR responses during the modified ECT.