Midazolam shortens seizure duration following electroconvulsive therapy

Loimer, Norbert; Hofmann, Peter; Chaudhry, H.R.

doi:10.1016/0022-3956(92)90001-5

Cited by 18 publications

(7 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the use of benzodiazepines for sedation, these drugs increase the seizure threshold and decrease the seizure duration and the potential effi cacy of ECT [20]. In the present study, midazolam kept seizure activity lasting long enough and also suppressed post-ECT agitation effi ciently, in contrast to the earlier reports [18,20]. The effects of midazolam on MAP, HR, patients' satisfaction, and recovery times were similar in group Dex and group C (P > 0.05).…”

Section: Discussioncontrasting

confidence: 82%

See 1 more Smart Citation

Premedication with dexmedetomidine and midazolam attenuates agitation after electroconvulsive therapy

et al. 2009

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 82%

“…However, Loimer et al [18] showed that midazolam shortened the seizures to a duration which was not therapeutically desirable. Q'Reardon et al [19] investigated benzodiazepines for postictal agitation (PIA) in a ten-patient series, and their fi ndings revealed a resistant agitation to the intravenous administration of benzodiazepines.…”

Section: Discussionmentioning

confidence: 98%

Premedication with dexmedetomidine and midazolam attenuates agitation after electroconvulsive therapy

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Reason for getting inadequate sedation could be employment of lower doses in range of 0.09-0.1mg/kg body weight, whereas Pratibha jain shah et al 2010 3, Arvind Arya, Manpreet Singh (2008), [4] used midazolam in the dose of 0.2mg/kg. N.Lomier, P. Hoffman and H.R Chaudhary (1992), [5] compared midazolam anaesthesia with thiopentone plus succinyl choline, midazolam significantly reduces seizure duration that was not therapeutically desirable and concluded that midazolam anaesthesia offers no advantage over standard anaesthetic drugs for ECT with thiopentone and succinyl choline chloride. In present study a short mean duration of muscle convulsion was observed with thiopentone i.e 20.76±9.09 seconds as compared to propofol which was 24.44±9.84 seconds (P = 0.052).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Thiopentone Sodium, Propofol and Midazolam for Modified Electro Convulsive Therapy

Kasliwal

Varshney

Neema

2019

AAN

View full text Add to dashboard Cite

Background: Modified Electroconvulsive therapy (MECT), is evidence based, safe and established treatment for varieties of psychiatric diseases that includes acute mania, major depressive disorder, schizophrenia, suicidal tendency and many more conditions. Government of India and world health organization has mandated use of sedative / anesthetic drug to make MECT acceptable method of treatment. MECT is administered under anesthesia to control acute cardiovascular, cerebrovascular and musculoskeletal changes occurring subsequent to delivery of electric current across the cerebral cortex. This also prevents respiratory and traumatic complications. Subjects and Methods: In the present clinical observational study we analyzed 113 MECT administrations for evaluating suitability of thiopentone sodium, propofol and midazolam with succinyl choline chloride; on 45 patients belonging to ASA grade II with no associated systemic diseases. Results: We observed the induction characteristics, induction and recovery time, associated changes in hemodynamic parameters during and after procedure, duration and energy required to induce muscular convulsions and changes in serum potassium level. Our observations indicates that induction was quicker with propofol than with thiopentone 43.67 ± 9.13v/s 61.31 ± 15.58 seconds and recovery time was also quicker with propofol than thiopentone 518.73 ± 69.67 v/s 595.25 ± 112.68 seconds. Only on one occasion in thiopentone group induction was turbulent. Acute but short lasting changes in heart rate, systolic, diastolic and mean arterial pressure was observed in both thiopentone and propofol groups. The energy requirement was less than 100 joules on 34 sittings in thiopentone group while in propofol group it was observed on 47 sittings. In thiopentone group on 17 occasion energy required were more than 100 joules and 5 sittings in propofol group. There was transient elevation of mean serum potassium of 0.55 mEq/lit after MECT in all patients. Midazolam did not produce satisfactory condition in dose of 5 mg and needed thiopentone supplement on 10 occasions. Conclusion: The findings allowed us to conclude that both thiopentone and propofol along with subparalytic dose of succinyl choline chloride produced satisfactory conditions for MECT sittings without complications. However propofol provided quick induction and recovery and lesser energy requirement.

show abstract

“…Benzodiazepines have consistently been shown to decrease the seizure duration, and possibly the therapeutic efficacy of both unilateral and bilateral ECT. Notably, a trial by Loimer et al which compared the efficacy of intravenous midazolam to intravenous thiopental in adult ECT was terminated early for ethical considerations as patients in the midazolam arm were unable to reach optimal seizure duration (15). Although low-dose intravenous midazolam (0.025 mgÁkg À1 ) does not appear to prolong seizure duration over control, the ability of this dose to provide adequate preprocedural anxolysis is unlikely and may result in paradoxical disinhibitory hyperactivity.…”

Section: Midazolammentioning

confidence: 99%

Anesthetic considerations for pediatric electroconvulsive therapy

Franklin

Sobey

Stickles

2017

Pediatric Anesthesia

View full text Add to dashboard Cite

Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population. Unique factors for pediatric electroconvulsive therapy include the potential need for preoperative anxiolytic and inhalational induction of anesthesia, which must be weighed against the detrimental effects of anesthetic agents on the evoked seizure quality required for a successful treatment. Dexmedetomidine is likely the most appropriate preoperative anxiolytic as oral benzodiazepines are relatively contraindicated. Methohexital, though becoming less available at many institutions, remains the gold standard for induction of anesthesia for pediatric electroconvulsive therapy though ketamine, propofol, and sevoflurane are becoming increasingly viable options. Proper planning and communication between the multidisciplinary teams involved in the care of children presenting for electroconvulsive therapy treatments is vital to mitigating risks and achieving the greatest therapeutic benefit.

show abstract

Midazolam shortens seizure duration following electroconvulsive therapy

Cited by 18 publications

References 8 publications

Premedication with dexmedetomidine and midazolam attenuates agitation after electroconvulsive therapy

Premedication with dexmedetomidine and midazolam attenuates agitation after electroconvulsive therapy

Evaluation of Thiopentone Sodium, Propofol and Midazolam for Modified Electro Convulsive Therapy

Anesthetic considerations for pediatric electroconvulsive therapy

Contact Info

Product

Resources

About