Anesthesia for electroconvulsive therapy: A Noble approach

Pal, Rashmi; Pal, V. S.

doi:10.5958/2319-5886.2015.00179.4

Cited by 6 publications

(10 citation statements)

References 30 publications

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“…To attenuate this acute hyperdynamic response, many pharmacological agents such as beta blockers, calcium channel blockers, alpha2-agonists, direct-acting vasodilators and local anaesthetics were tried. [2][3][4][5] Dexmedetomidine is a potent as well as highly selective α2adrenergic agonist with a sedative, sympatholytic and analgesic effect. It has been described as a safe and effective additive in many anaesthetic applications and analgesic techniques.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine in premedication to attenuate the acute hyperdynamic response to ECT: a randomised, double-blind, controlled study

Bagle

Thatte

Kate

2016

Southern African Journal of Anaesthesia and Analgesia

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The choice of anaesthetic agent for electroconvulsive therapy (ECT) depends on seizure duration, haemodynamic and recovery parameters. The aim of the study was to assess the effects of dexmedetomidine premedication on haemodynamic, seizure duration, recovery characteristics and agitation following ECT. Material and method: 60 patients aged 18-60 years scheduled for ECT were enrolled in the study. Dexmedetomidine (0.5 μg/kg) diluted to 10 ml with 0.9% saline or 10 ml 0.9% saline (control) were infused intravenously over 10 min before induction of anaesthesia with thiopentone. Motor seizure duration, heart rate, mean arterial blood pressure, time to spontaneous respiration, obeying verbal commands and post-ECT agitation score were recorded. Statistical analysis was carried out using MS Excel and Primer of Biostatistics. Results: Post-ECT rise in mean arterial blood pressure (MAP) and heart rate (HR) in the dexmedetomidine group was significantly less (p < 0.001) compared with the control group at 1, 3, and 5 mins. Motor seizure duration was comparable in both groups. Mean agitation score was significantly low in the dexmedetomidine group (1.5 ± 0.50) compared with the control group (1.93 ± 0.52). Conclusion: A dexmedetomidine dose of 0.5 μg/kg IV administered over 10 min before the induction of anaesthesia may be useful in preventing the acute hyperdynamic responses to ECT and post-ECT agitation without altering the duration of seizure activity and recovery time.

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Section: Introductionmentioning

confidence: 99%

Dexmedetomidine in premedication to attenuate the acute hyperdynamic response to ECT: a randomised, double-blind, controlled study

Bagle

Thatte

Kate

2016

Southern African Journal of Anaesthesia and Analgesia

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“…Many antihypertensive drugs have been administered in an attempt to attenuate the acute autonomic response to ECT. Previously Diazoxide, Hydralazine, β blockers (Esmolol, Labatolol, Propanolol) , Calcium-channel blockers (Nicardipine, Nifedipine) Direct vasodilators( Nitroglycerine) and α2 Agonists/Antagonists( Clonidine), Opioid analgesics(Remifentanyl, Alfentanil ) have been used ; (2,4,6) however, the duration of action of these agents is longer than the ECT procedure and anesthesia time. However, when seizure duration is less than 15 seconds in both motor and EEG manifestations , the seizure was limited by insufficient electrical stimulation and that the treatment was inadequate.…”

Section: Discussionmentioning

confidence: 99%

“…(2,4) Now the number of ECT procedures performed each year under general anesthesia. (2) The mechanism of action of ECT is not fully known.…”

Section: Discussionmentioning

confidence: 99%

“…This response consists of an initial parasympathetic and a subsequent sympathetic reaction. (1,2,4,6,7) The essential elements of anesthesia for ECT include rapid loss of consciousness, effective attenuation of the hyperdynamic response to the electrical stimulus, avoidance of gross movements, minimal interference with seizure activity and prompt recovery of spontaneous ventilation and consciousness. (2,4) Fentanyl can be used as premedication to reduce haemodynamic response during ECT.…”

Section: Introductionmentioning

confidence: 99%

“…(1,2,4,6,7) The essential elements of anesthesia for ECT include rapid loss of consciousness, effective attenuation of the hyperdynamic response to the electrical stimulus, avoidance of gross movements, minimal interference with seizure activity and prompt recovery of spontaneous ventilation and consciousness. (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.…”

Section: Introductionmentioning

confidence: 99%

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Role of Fentanyl in Attenuation of Haemodynamic Changes during Electroconvulsive Therapy

Gandhi¹,

Padya²,

Chavda³

et al. 2018

IJABMS

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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.

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The Historical Struggles of Modified Electroconvulsive Therapy: How Anesthesia Came to the Rescue

Lava-Parmele

Lava²,

Parmele

2021

Journal of Anesthesia History

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Anesthesia for electroconvulsive therapy: A Noble approach

Cited by 6 publications

References 30 publications

Dexmedetomidine in premedication to attenuate the acute hyperdynamic response to ECT: a randomised, double-blind, controlled study

Dexmedetomidine in premedication to attenuate the acute hyperdynamic response to ECT: a randomised, double-blind, controlled study

Role of Fentanyl in Attenuation of Haemodynamic Changes during Electroconvulsive Therapy

The Historical Struggles of Modified Electroconvulsive Therapy: How Anesthesia Came to the Rescue

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