Effects of Remifentanil on Convulsion Duration and Hemodynamic Responses During Electroconvulsive Therapy

Nasseri, Karim; Arasteh, Mehdi Tayebi; Maroufi, Azad; Shami, Shoaleh

doi:10.1097/yct.0b013e318199f767

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…7,8 Propofol is a short-acting hypnotic agent, chemically distinct from barbiturates, that is widely used for general anesthesia for operative procedures, as well as for ECT. Other agents that are frequently used for ECT include thiopental, ketamine, and etomidate.…”

mentioning

confidence: 99%

A Within-Subject Comparison of Propofol and Methohexital Anesthesia for Electroconvulsive Therapy

Vaidya¹,

Anderson²,

Bobb³

et al. 2012

The Journal of ECT

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mentioning

confidence: 99%

A Within-Subject Comparison of Propofol and Methohexital Anesthesia for Electroconvulsive Therapy

Vaidya¹,

Anderson²,

Bobb³

et al. 2012

The Journal of ECT

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“…They found no difference between ketamine and methohexitone in relation to peak HR and SBP, whereas DBP was found to be higher among patients receiving ketamine. Rasmussen et al 13 found that blood pressurewas higher in the ketamine group than in the methohexitone group. Ketofol may provide a better haemodynamic stability compared with the ketamine alone.…”

Section: Discussionmentioning

confidence: 97%

“…A difference of at least six seconds of seizure duration between two groups was considered clinically significant as observed in a previous study 13 . For a power of 0.8 and α=0.05, a sample size of 11 patients in each group was required.…”

Section: Methodsmentioning

confidence: 99%

Ketofol (Mixture of Ketamine and Propofol) Administration in Electroconvulsive Therapy

Kayhan

Yücel

Çolak

et al. 2012

Anaesth Intensive Care

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Electroconvulsive therapy (ECT) is a common treatment method used in severe depression and other psychiatric diseases. Currently, most ECT procedures are carried out with muscle paralysis under general anaesthesia. The anticonvulsant properties of sedative and hypnotic drugs used during general anaesthesia may reduce the efficacy of ECT. It is important to establish an accurate balance between adequate anaesthesia depth and optimal seizure duration. Moreover, the electrical current applied during the ECT stimulates the autonomic nervous system and leads to haemodynamic changes in both systemic and cerebral circulations 1. As anaesthetists play a critical role in

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“…First, we utilized endotracheal intubation or a laryngeal mask in order to provide sufficient oxygenation and to prevent hypercapnia. Second, we selected remifentanil for anesthesia, because it has strong anti-nociceptive features and was expected to stabilize blood pressure [ 11 ]. Third, we had an NO appliance available in case of PH crisis.…”

Section: Discussionmentioning

confidence: 99%

A case of malignant catatonia with idiopathic pulmonary arterial hypertension treated by electroconvulsive therapy

et al. 2016

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BackgroundIdiopathic pulmonary arterial hypertension (IPAH) is a progressive and fatal cardiovascular disease if left untreated. In patients with IPAH with psychiatric illness or other complications, careful attention is required when administering medical therapies that may affect their hemodynamics. Patients suffering from IPAH who undergo anesthesia and surgery have a high mortality and morbidity rate. We describe the treatment of intractable psychiatric symptoms with electroconvulsive therapy (ECT) in a patient with IPAH.Case presentationA 23-year-old woman with IPAH and type I diabetes mellitus (DM) presented with malignant catatonia. Her heart function was classified as New York Heart Association (NYHA) class III. She required a rapid cure and ECT due to various psychiatric symptoms resistant to conventional medications. Pulmonary hypertensive (PH) crisis is the most concerning complication that can be induced by the sympathetic stimulation of ECT. To avoid PH crisis, we administered oxygen using a laryngeal mask and administered remifentanil for anesthesia. We also prepared standby nitric oxide for possible PH crisis, although it was ultimately not needed. With 14 ECT sessions, her malignant catatonia was ameliorated without physical complications.ConclusionECT is an acceptable option for the treatment of medication-refractory psychiatric disturbances in patients with IPAH, provided careful management is assured to prevent or address complications.

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Effects of Remifentanil on Convulsion Duration and Hemodynamic Responses During Electroconvulsive Therapy

Abstract: Remifentanil (1 microg/kg) administered before thiopental (1 mg/kg) has no adverse effect on the duration of ECT-induced convulsion and recovery time, but it can attenuate the increase in heart rate and arterial blood pressure.

Cited by 12 publications

References 19 publications

A Within-Subject Comparison of Propofol and Methohexital Anesthesia for Electroconvulsive Therapy

A Within-Subject Comparison of Propofol and Methohexital Anesthesia for Electroconvulsive Therapy

Ketofol (Mixture of Ketamine and Propofol) Administration in Electroconvulsive Therapy

A case of malignant catatonia with idiopathic pulmonary arterial hypertension treated by electroconvulsive therapy

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