Twelve ASA physical status I-III patients were enrolled in a double-blind, prospective, randomized, three-way, withinpatient Electroconvulsive therapy (ECT) may produce intense stimulation of the central nervous system resulting in hypertension and tachycardia, t'2 The haemodynamic effects of ECT could place the patient with coronary or cerebrovascular disease at risk of myocardial ischaemia/ infarction or stroke. 3-5 Esmolol hydrochloride (Brevibloc) is a new ultra-short acting betal selective adrenergic blocking agent. Esmolol bolus 6 and infusion 7 have been found to be effective in attenuating the cardiovascular response to ECT. However, comparison of the effects of different standardized bolus doses and their effect on the Douze patients de classe ASA I-III ont particip~ d trois sdances varides de notre (tude randomisde d double insu sur l'effet de deux doses d'esmolol en bolus (100 et 200 mg) sur les variables hdmodynamiques et la durde des convulsions assocides at•r dlectrochocs ( EC ). On leur injectait I'esmolol ou un placdbo une minute avant I' induction de l'anesthdsie puis detzx minutes avant

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To determine whether a standardized dose of esmolol can effectively attenuate the cardiovascular response to electroconvulsive therapy (ECT), 17 ASA physical status I-II patients were studied in a randomized within-patient, crossover design. Each patient received "no esmolol" during one ECT and three to five days later crossed over to the alternative treatment receiving an esmolol 80 mg bolus followed by 24 mg.min-1 infusion two minutes prior to induction of anaesthesia and continued for five minutes after induction. Esmolol blunted the maximum increases in heart rate (HR) by 26 per cent, mean arterial pressure (MAP) by 14 per cent, and rate pressure product by 37 per cent with significant differences (P less than 0.05) noted at one, two, three and four minutes after ECT (minutes five, six, seven, and eight of the esmolol infusion). There was no significant difference in seizure duration between the two groups and no adverse reactions occurred.

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