Patients’ Physical Response to Thiopental and Alternative Anesthetic Agents in the Setting of Electroconvulsive Therapy

Gordon, Kayleigh; Woloschuk, Donna M M; Walus, Ashley

doi:10.4212/cjhp.v67i6.1408

Cited by 4 publications

(8 citation statements)

References 14 publications

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“…The reason for the differences among the results might be multifactorial, and partly due to the different structures regarding population selection, study duration, the number of treatment sessions, and the intervals. For example, unavoidable variability among patients affects seizure duration ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

The Incidence and Predictors of Headache and Myalgia in Patients After Electroconvulsive Therapy (ECT)

et al. 2016

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Background:Electroconvulsive therapy (ECT) is a safe and effective mode of therapy for a wide variety of psychiatric disorders. However, it is associated with some disturbing side effects, such as nausea and vomiting, dental and tongue injury, confusion, dizziness, headache, and myalgia.Objectives:The present study focused on the evaluation of myalgia and headache and their predictors after ECT.Patients and Methods:A prospective analytical descriptive study was conducted from October 2014 to January 2015, in an academic hospital in northern Iran. Before sampling, the study was approved by the ethics committee of Guilan University of Medical Sciences. 621 patients with psychiatric disorders who were referred to Shafa hospital enrolled in the study. They were evaluated based on a verbal rating scale (4 point scales) 6 hours after ECT, regarding headache and myalgia side effects.Results:6 hours after ECT, 126 patients (21.9%) reported headaches, and 56 patients (9%) reported myalgia. The presence of headache or myalgia 6 hours after ECT was not correlated to the duration of convulsion, treatment sessions, sex, or age. But myalgia at 2 hours after treatment was correlated with sex (0.04). Sex, age, duration of seizure, and treatment sessions were not predictors of headache and myalgia 6 hours after ECT (log regression, enter mode). The intensity and frequency of headaches decreased during 6 hours after ECT (P = 0.0001 and P = 0.0001, respectively), and myalgia frequency decreased (P = 0.062) but the intensity increased (P = 0.87).Conclusions:The results of the present study demonstrate that headache after ECT procedures was more common than myalgia, but it was mild, tolerable, and decreased within 6 hours of the treatment. It is also notable that we did not found any predictors for post-ECT headache and myalgia.

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Section: Discussionmentioning

confidence: 99%

The Incidence and Predictors of Headache and Myalgia in Patients After Electroconvulsive Therapy (ECT)

et al. 2016

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“…The advantages of propofol over methohexital include a quicker and smoother emergence from anesthesia and a somewhat more favorable hemodynamic profile. 14 – 17 Dis-advantages are its much greater anticonvulsant effect and higher cost. Etomidate is an alternative particularly in patients who have seizures of short duration or hard to elicit.…”

Section: Medications During the Ect Proceduresmentioning

confidence: 99%

“…Etomidate is an alternative particularly in patients who have seizures of short duration or hard to elicit. 14 , 17 , 20 Ketamine has shown to be slightly proconvulsant and has intrinsic antidepressant properties. Disadvantages include hypertension and occasional transient dissociative symptoms on wake up.…”

Section: Medications During the Ect Proceduresmentioning

confidence: 99%

“…Disadvantages include hypertension and occasional transient dissociative symptoms on wake up. 17 , 19 , 21 A recent systematic review concluded that robust evidence to recommend a particular induction agent for ECT is lacking and indicated that anesthetic agents should be chosen on the basis of adverse effect profile, emergence, and how these medications affect seizure duration. 18 Opioids, such as remifentanil and alfentanil, combined with anesthetic agents have been used to increase the seizure duration by an induction agent dose-sparing effect.…”

Section: Medications During the Ect Proceduresmentioning

confidence: 99%

“… 18 Opioids, such as remifentanil and alfentanil, combined with anesthetic agents have been used to increase the seizure duration by an induction agent dose-sparing effect. 17 , 22 – 24 Caffeine, in the form of caffeine sodium benzoate intravenous injection 250–1,000 mg, and other methylxanthines have also been administered prior to ECT to increase the seizure duration but do not appear to reduce seizure threshold. 24 However, because the potential cardiac and other complications of caffeine use are known, this augmenting strategy is not generally recommended, especially in the elderly.…”

Section: Medications During the Ect Proceduresmentioning

confidence: 99%

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Medication management during electroconvulsant therapy

Zolezzi¹

2016

NDT

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Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords.

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Thiopental sodium

2016

Reactions Weekly

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Patients’ Physical Response to Thiopental and Alternative Anesthetic Agents in the Setting of Electroconvulsive Therapy

Cited by 4 publications

References 14 publications

The Incidence and Predictors of Headache and Myalgia in Patients After Electroconvulsive Therapy (ECT)

The Incidence and Predictors of Headache and Myalgia in Patients After Electroconvulsive Therapy (ECT)

Medication management during electroconvulsant therapy

Thiopental sodium

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