The Effect of Remifentanil on Seizure Duration and Acute Hemodynamic Responses to Electroconvulsive Therapy

Recart, Alejandro; Rawal, Shivani; White, Paul F.; Byerly, Stephanie I.; Thornton, Larry

doi:10.1213/01.ane.0000054002.65040.b3

Cited by 54 publications

(36 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the authors also demonstrated that remifentanil did not significantly suppress increases in MAP and HR during mECT and speculated that a too low remifentanil dose or reduction in the methohexital dose could affect hemodynamic changes. Recart et al reported that remifentanil, when administered with methohexital, suppressed increases in the MAP [24]. Locala et al reported that increases in HR and MAP could be suppressed by a combined single injection of methohexital and 500 μg of remifentanil [25].…”

Section: Discussionmentioning

confidence: 99%

Remifentanil can Prevent the Increase in Qt Dispersion During Modified Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

Kageyama¹,

Hamaguchi²

2015

J Anesth Clin Res

View full text Add to dashboard Cite

Objective: To clarify the hemodynamic-stabilizing effect of remifentanil in the context of modified electroconvulsive therapy (mECT), we measured electrocardiographic alterations in the corrected QT interval (QTc) and corrected QT dispersion (QTcD), considered predictive of ventricular arrhythmia, during mECT. Methods:Sixty patients scheduled for mECT were divided randomly into 3 groups. Patients in the low-dose remifentanil administration group (group L, N=20) were administered 0.5 μg/kg of remifentanil before mECT. Patients in the high-dose group (group H, N=20) were administered 1.0 μg/kg of remifentanil, and those in the control (group C, N=20) were administered a similar volume of normal saline solution. Modified ECT was performed in the same manner in all groups with propofol and suxamethonium. Changes in QTc and QTcD values were analyzed using a repeated measures analysis of variance, and between-group comparisons were conducted using the Bonferroni method.Results: During mECT, an increase in the mean arterial pressure, decrease in the R wave-to-R wave interval, elongation of QTc, and increase in QTcD were observed in group C, whereas these alterations were attenuated in group L and were not observed in group H. The differences observed in group C relative to the other groups were statistically significant (P<0.05). Conclusion:Compared with the control treatment and a 0.5 μg/kg dose, a 1.0 μg/kg dose of remifentanil had a preventive effect on ventricular arrhythmia after mECT, as well as on hemodynamic changes, according to the observed alterations in QTc and QTcD. Therefore, our results indicate that a 1.0 μg/kg dose of remifentanil could suppress hemodynamic changes, prevent myocardial ischemia or cerebral hemorrhage, and minimize the development of fatal arrhythmias such as ventricular tachycardia and/or ventricular fibrillation.

show abstract

Section: Discussionmentioning

confidence: 99%

Remifentanil can Prevent the Increase in Qt Dispersion During Modified Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

Kageyama¹,

Hamaguchi²

2015

J Anesth Clin Res

View full text Add to dashboard Cite

show abstract

“…Another study [14] showed that attenuation of the acute hypertensive response following ECT during methohexital anesthesia required at least 100 lg remifentanil (2 lg/kg). In addition, a sympathetic response caused by the ECT stimulus results in severe tachycardia and hypertension peaking 3-5 min [15] and lasting 5-7 min [10] after the electrical stimulus.…”

Section: Discussionmentioning

confidence: 99%

Effect of divided supplementation of remifentanil on seizure duration and hemodynamic responses during electroconvulsive therapy under propofol anesthesia

et al. 2010

View full text Add to dashboard Cite

show abstract

“…(2,4) Fentanyl can be used as premedication to reduce haemodynamic response during ECT. (2,3,5,6,8) When it is used, there is transient increase in Heart rate and Blood pressure but it comes to preoperative status soon. During ECT noninvasive monitors were used to record Heart rate, Blood pressure, Oxygen saturation.…”

Section: Introductionmentioning

confidence: 99%

Role of Fentanyl in Attenuation of Haemodynamic Changes during Electroconvulsive Therapy

Gandhi¹,

Padya²,

Chavda³

et al. 2018

IJABMS

View full text Add to dashboard Cite

BACKGROUND AND AIMS :The use of Electroconvulsive therapy as a treatment modality has increased over the recent years. Electroconvulsive therapy (ECT) is associated with transient episodes of hypertension and tachycardia.Various agents like Beta-blocking agents, Opioids, Nitroglycerine and Clonidine are used to prevent cardiovascular response. Aim of our study was to assess the efficacy of Fentanyl on cardiovascular response and seizure duration during ECT. MATERIAL AND METHOD : 60 patients aged 18-60 years with ASA Grade I or II undergoing ECT were divided into Group A patients who received Inj.Fentanyl 1 mcg/kg intravenously and Group B patients who did not received Inj. Fentanyl 1 mcg/kg. The haemodynamic changes and seizure duration were recorded and tested by Mean, Standard deviation, Percentage, P value for significance. RESULTS : The haemodynamic changes after giving ECT were less in Fentanyl Group A (P<0.05) as compared to Nonfentanyl Group B and vitals came to baseline value earlier in Fentanyl group than Nonfentanyl group. Seizure duration was not affected by Fentanyl (P>0.05). CONCLUSION : Those patients receiving ECT when given Inj. Fentanyl 1 mcg/kg intravenously were seen to be more haemodynamicaly stable as compared to those patients who did not received Inj.Fentanyl intravenously.

show abstract

The Effect of Remifentanil on Seizure Duration and Acute Hemodynamic Responses to Electroconvulsive Therapy

Abstract: Remifentanil (100 microg IV) attenuated the acute hemodynamic response after electroconvulsive therapy (ECT) without adversely affecting the length of the ECT-induced seizure activity or prolonging recovery times.

Cited by 54 publications

References 22 publications

Remifentanil can Prevent the Increase in Qt Dispersion During Modified Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

Remifentanil can Prevent the Increase in Qt Dispersion During Modified Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

Effect of divided supplementation of remifentanil on seizure duration and hemodynamic responses during electroconvulsive therapy under propofol anesthesia

Role of Fentanyl in Attenuation of Haemodynamic Changes during Electroconvulsive Therapy

Contact Info

Product

Resources

About