| Objective In recent years,the number of patients with mental disorders in China is increasing year by year and the patients are getting younger and younger,especially the patients with depressive disorders,among the patients with depressive disorders,especially the patients with TRD are the most serious and the most difficult to treat,because the patients with TRD have poor effect on medication,the first choice for treating the patients with TRD is non-convulsive electroconvulsive therapy.The inhalation anesthetic sevoflurane,which is widely used in daily surgery,is widely used for its low airway irritation,rapid induction of anesthesia,stable awakening,and easily adjustable depth of anesthesia.It is widely used in surgical procedures and MECT treatment of mental disorders.In this study,the effects of MECT with sevoflurane as the anesthetic agent on serum brain-derived neurotrophic factor,cognitive function and human hemodynamic physiological parameters in TRD patients were investigated.Methods From January 2019 to January 2020,60 eligible TRD patients admitted to the psychiatric department of Chaohu Hospital affiliated to Anhui Medical University,aged 20-60 years,with ASA grading in grade I-II,were randomly selected and selected,and the patients’ clinical diagnosis met the TRD diagnostic grading criteria;HAMD depression score of 24 items ≥ 20.A variety of serious complications such as intracranial hypertensive diseases,respiratory diseases,cardiovascular diseases,etc.;the presence of a history of hormonal drug abuse;serious adverse reactions related to anesthetic drugs;and women during pregnancy or lactation were also excluded.They were randomly divided into sevoflurane group(S group)and propofol group(P group)according to the chaotic number table,30 in each group.The patients were anesthetized with sevoflurane and propofol,respectively,during the administration of MECT treatment for 8 sessions,and the basal MAP and H R values before anesthesia and the peak MAP and HR after electrical stimulation were recorded;the HAMD scores of patients in both groups were recorded 1 day before treatment and after each subsequent session,and the RBANS of patients in both groups were recorded one day before and one day after the end of treatment scores,recording the serum BDNF concentration levels of patients in both groups on the day before and after each treatment.Results In the comparison of the two groups of patients,the HR value after electrical stimulation was significantly higher in group S than in group P [(127.63 ± 12.88)times vs(111.50 ± 12.06)times],and the MAP value was significantly higher than in group P[(114.67 ± 8.75)mm Hg vs(107.40 ± 10.94)mm Hg],and the difference between the two groups was statistically There was no statistically significant difference in serum BDNF concentrations between and within the two groups after MECT treatment(P >0.05);immediate memory,structural speech,functional attention and delayed memory in the RBANS scores were significantly higher in the S group than in the P group(P <0.05).T continuous treatment showed a significant decrease in HAMD score values in both groups compared to the pre-treatment period,and the HAMD scores in the S group were significantly lower than those in the P group after each session of MECT treatment(P < 0.05).Conclusion The use of sevoflurane as an anesthetic agent in MECT for the treatment of patients with refractory depression was significantly better than propofol in terms of reducing the effect of HAMD scores and improving the cognitive function of patients,but it had a negative effect on hemodynamic aspects would increase the heart rate and blood pressure of patients for a short period of time after electrical stimulation,and there was no significant change in serum BDNF concentrations in patients with TRD. |
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