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Objective: modern electroconvulsive therapy (Mordern electroconvulsive therapy, MECT) is a common treatment for patients with depression. , MECT propofol intravenous anesthesia, recent research found that intravenous anesthetic ketamine has a fast, powerful, and relatively long-lasting antidepressant effect. However, the effect of ketamine on the cardiovascular system stimulant adverse reactions of nausea and vomiting after anesthesia as well as psychiatric symptoms, often used for patients with propofol combined with clinical anesthesia due to propofol cardiovascular depression, antiemetic, sedation . Therefore, the present study was to investigate the ketamine anesthetic propofol combined with electroconvulsive therapy in patients with depression efficacy. Methods: Using a randomized, double-blind design study intended first MECT, Hamilton depression score 20 points or more patients with depression (Hamilton depression rating score, HDRS) were randomly divided into three groups, namely the propofol group (P, n = 12), ketamine group (K, n = 12) and propofol combined with ketamine group (PK, n = 16), respectively, with 1.5mg/kg propofol, 0.8mg/kg ketamine, 1.5mg/kg isopropyl phenol 0.8mg/kg ketamine of MECT narcotic drugs. All patients were in MECT one day before, MECT 1,2,3,7-day assessment HDRS, a record the MECT during convulsions energy index (Seizure energy index, SEI) twitch duration (Seizure duration, SD) and related adverse reactions, MECT accept conventional antidepressant treatment; clinical efficacy judgments: HDRS decreases compared to baseline values ??50% and more clinically effective, the HDRS ≤ 7 divided into clinical cure. Results: three groups of patients MECT HDRS was no significant difference (p gt; 0.05), but the 1,2,3,7 days after MECT the HDRS than those the MECT significantly lower (p lt; 0.05); compared with group P, K and the the PK group MECT after 1,2,3,7 days the HDRS significantly reduce (p lt; 0.05); compared with Group K, 1, 2, 3, 7 days after the PK group MECT HDRS was no significant difference (p gt; 0.05) ; the P group MECT first three days clinically effective patient only the MECT after the 7 days in 7 patients (58%) patients achieved clinically effective no clinical cure patients; 1 day after the K group MECT patients with clinically effective in 11 patients (92% ), 2,3,7-day clinical effective patient reached 12 cases (100%), seven days after the MECT 7 cases (58%) patients achieved clinical cure; one day after the PK group MECT patients with clinically effective in 12 patients (75 %), 2,3,7-day clinical effective patient reaches 16 cases (100%), seven days after the MECT 8 cases (50%) patients achieved clinical cure; compared with group P, K and PK group MECT during SEI increased significantly and extend and SD (p lt; 0.05); compared with the K group, the PK group adverse reactions was significantly lower (p lt; 0.05). Conclusion: Propofol combined with ketamine for MECT anesthesia can quickly and significantly improve the efficacy of the depressed patients, and reduce adverse reactions caused by ketamine anesthesia alone; ketamine itself has antidepressant effects as well as the MECT during induced higher convulsions energy index and longer twitch time may be one of the mechanisms
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