Effects on Intracranial Pressure of Electroconvulsive Therapy

†Rijnstate Hospital, Arnhem
The journal of ECT (Impact Factor: 1.39). 06/2012; 28(2):e23-4. DOI: 10.1097/YCT.0b013e31824d9b69
Source: PubMed


Electroconvulsive therapy (ECT) is thought to raise intracranial pressure (ICP) after an increase of blood pressure. In depressed patients (n=17) treated with ECT, using transcranial Doppler, pulsatility index (PI; as indicator of ICP) and blood pressures were prospectively measured. The highest PI was measured just after anesthesia induction and muscle relaxation. Blood pressures increased significantly after succinylcholine and thereafter but did not correlate to PI. After anesthesia and muscle relaxation, the PI was higher than just before ECT; the PI was lower during seizure activity and after ECT. Therefore, ECT itself seemed not to raise ICP.

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    ABSTRACT: Objective: We aimed to compare the effects of rocuronium-sugammadex and succinylcholine on the recovery and side effects during the electro-convulsive therapy (ECT). Methods: Patients who received at least six sessions ECT are involved into this study. For general anesthesia, following 1 mg/kg propofol, rocuronium or succinylcholine were applied. After ECT process, succinylcholine group was left to recovery on its own, but rocuronium group was received 4 mg/kg sugammadeks. Heart rate, mean blood pressure, oxygen saturation, spontaneous breathing time, time of opening eyes, time of obeying the instructions, motor seizure duration, side effects, timing of T1 0% and 90%, Modified Aldrete Scores (MAS) and timing of MAS 9 were recorded. Results: When the groups were compared, time of T1 being 0% in succinylcholine group was meaningfully shorter. Time of T1 being 90% was shorter in rocuronium-sugammadex group. Motor seizure duration was longer in the rocuronium-sugammadex group. After ECT process MAS was found lower in the rocuronium-sugammadex group, timing of MAS 9 was shorter in rocuronium-sugammadex group. Opening eyes, obeying the instructions and spontaneous breathing time were shorter in rocuronium-sugammadex group. Conclusion: Use of rocuronium-sugammadex combination provides sufficient muscle relaxation and early recovery during ECT. Rocuronium-sugammadex can be used as an alternative to succinylcholine in ECT. Key words: electroconvulsive therapy, sugammadex, rocuronium, succinylcholine, recovery
    Full-text · Article · Jun 2015 · Anadolu Psikiyatri Dergisi