ICJEM
Intercontinental Journal of Emergency Medicine

The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

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Original Article
A comparison of the effects of succinylcholine and rocuronium on recovery time from anesthesia and vital signs in electroconvulsive therapy
Abstract
Aims: Electroconvulsive therapy (ECT) is based on stimulation of brain tissue with an electrical current and the induction of generalized convulsions. The aim of this study was to compare the use of rocuronium as a muscle relaxant and sugammadex as an antidote during ECT with succinylcholine in terms of its effect on adequate anesthesia, hemodynamics, and recovery.
Methods: This study was planned as a single-center prospectively collected and retrospectively analyzed observational cohort study. Patients were divided into two groups as group S (succinylcholine) and group R+S (rocuronium and sugammadex). Patients were premedicated with 0.5 mg of atropine I.M. half an hour before the procedure. Propofol 1mg/kg was administered as an induction agent in both groups, succinylcholine 1mg/kg in Group S, and rocuronium 0.4mg/kg in Group R+S. Sugammadex 2mg/kg was administered as a rocuronium antidote. Vital signs were monitored throughout the procedure with ECG, spo2, and blood pressure monitoring.
Results: There was a statistically significant difference between the two groups (Group S and Group R+S) in the time to return for spontaneous respiration (p=0.002). The mean SSS value was 111.78 seconds in Group S and 88.82 seconds in Group R+S. There was a statistically significant difference between the spontaneous eye-opening times between Group S and Group R+S. (p=0.017) The mean SGA value was 211.42 seconds in Group S and 173.12 seconds in Group R+S. There was a statistically significant difference between Group S and Group R+S in the duration of modified Aldrete score 9 (p=0.000<0.05). The mean duration of MAS 9 was 542.60 seconds in Group S and 410.54 seconds in Group R+S.
Conclusion: In conclusion, although the high cost of rocuronium sugammadex limits its routine use in ECT anesthesia, it can be used as an ideal alternative agent in cases where succinylcholine is contraindicated or anticholinesterases are not suitable because it shortens the recovery time and the time to return of spontaneous respiration compared to succinylcholine.

Keywords : Electroconvulsive therapy, anesthesia recovery period, succinylcholine, rocuronium, vital signs

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1. Wells DG, Davies GG, Rosewarne F. Attenuation of electroconvulsivetherapy induced hypertension with sublingual nifedipine. AnaesthIntensive Care. 1989;17(1):31-33.
2. Avramov MN, Stool LA, White PF, Husain MM. Effects of nicardipineand labetalol on the acute hemodynamic response to electroconvulsivetherapy. J Clin Anesth. 1998;10(5):394-400.
3. Wajima Z, Yoshikawa T, Ogura A, et al. The effects of diltiazem onhemodynamics and seizure duration during electroconvulsive therapy.Anesth Analg. 2001;92(5):1327-1330.
4. Fu W, Stool LA, White PF, Husain MM. Is oral clonidine effective inmodifying the acute hemodynamic response during electroconvulsivetherapy? Anesth Analg. 1998;86(5):1127-1130.
5. Milstein V, Small JG. Problems with lithium combined with ECT. Am JPsychiatry. 1988;145(9):1178.
6. G&uuml;rsoy Y, Sağıroğlu E. Elektrokonv&uuml;lsif tedavi ve anestezi. EgePsikiyatri S&uuml;rekli Yayınları. 1998;3(2):333-352.
7. Omoigui S. The Anesthesia Drugs Handbook. 2nd ed. Mosby: 1995.
8. Rasmussen KG, Jarvis MR, Zorumski CF. Ketamine anesthesia inelectroconvulsive therapy. Convuls Ther. 1996;12(4):217.
9. Reddy RV, Moorthy SS, Dierdorf SF, Deitch Jr RD, Link L. Excitatoryeffects and electroencephalographic correlation of etomidate,thiopental, methohexital and propofol. Anesth Analg. 1993;77(5):1008.
10. Mirzakhani H, Welch CA, Eikermann M, Nozari A. Neuromuscularblocking agents for electroconvulsive therapy: a systematic review. ActaAnaesthesiol Scand. 2012;56(1):3-16.
11. Bom A, Hope F, Rutherford S, Thomson K. Preclinical pharmacology ofsugammadex. J Crit Care. 2009;24(1):29-35.
12. Fuchs-Buder T, Meistelman C, Raft J. Sugammadex: clinical developmentand practical use. Korean J Anesthesiol. 2013;65(6):495-500.
13. Bom A, Hope F, Rutherford S, Thomson K. Preclinical pharmacology ofsugammadex. J Crit Care. 2009;24(1):29-35.
14. Turkkal DC, Gokmen N, Yildiz A, et al. A cross-over, post-electroconvulsivetherapy comparison of clinical recovery from rocuronium versussuccinylcholine. J Clin Anesth. 2008;20(8):589-593.
15. Lee C, Jahr JS, Candiotti KA, Warriner B, Zornow MH, Naguib M.Reversal of profound neuromuscular block by sugammadex administeredthree minutes after rocuronium: a comparison with spontaneousrecovery from succinylcholine. Anesthesiol. 2009;110(5):1020-1025.
16. Sarı&ccedil;i&ccedil;ek V, Şahin L, B&uuml;lb&uuml;l F, Ucar S, Sahin M. Does rocuronium-sugammadex reduce myalgia and headache after electroconvulsivetherapy in patients with major depression? J ECT. 2014;30(1):30-34.
17. Batistaki C, Kesidis K, Apostolaki S, Kostopanagiotou G. Rocuroniumantagonized by sugammadex for series of electroconvulsive therapy (ECT)in a patient with pseudocholinesterase deficiency. J ECT. 2011;27(1):e47-e48.
18. Trzepacz PT, Weniger FC, Greenhouse J. Etomidate anesthesia increasesseizure duration during ECT. Gen Hosp Psychiatry. 1993;15(2):115-120.
19. Mitchell P, Smythe G, Torda T. Effect of the anesthetic agent propofolon hormonal responses to ECT. Biol Psychiatry. 1990;28(4):315-324.
20. Avramov MN, Husain MM, White PF. The comparative effectsof methohexital, propofol and etomidate for ECT. Anest Analg.1995;81(3):596-602.
21. Sanli M, Toprak HI, Ozgul U, Bucak N, Ersoy MO. The use of rocuroniumwith sugammadex in electroconvulsive therapy of the patient withneuroleptic malignant syndrome: case report. J Turgut Ozal Med Cent.2014;21(1):71-73. doi: 47/jtomc.2013.1176
Article available in :
Volume 2, Issue 1, 2024
Page : 1-5
https://doi.org/10.51271/ICJEM-0026
Article Information
Received : 29 Kas 2023
Accepted : 27 Ara 2023
Published : 17 Mar 2024
Corresponding Author :

İnsaf Karaca Bent: Kartal Dr. Lütfi Kırdar City Hospital, Department of Anesthesiology and Reanimation

[email protected]
Citation : Karaca Bent İ, Köşlük Gürler H, Ekinci O. A comparison of the effects of succinylcholine and rocuronium on recovery time from anesthesia and vital signs in electroconvulsive therapy. Intercont J Emerg Med. 2024;2(1):1-5.

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