Psychiatry Investig.  2022 Oct;19(10):824-831. 10.30773/pi.2022.0123.

Does the Use of Rocuronium-Sugammadex Instead of Succinylcholine in Electroconvulsive Therapy Affect Seizure Duration?

• Oflezer C
• Atay Ö
• Kaşdoğan ZE
• Özakay G
• İpekçioğlu D
• Bahadır H

• KMID: 2535969
• DOI: http://doi.org/10.30773/pi.2022.0123

Abstract

Objective
We compared retrospectively the seizure variables of electroconvulsive therapy (ECT) patients after administration of rocuronium-sugammadex or succinylcholine as a muscle relaxant with propofol anesthesia.
Methods
The sample comprised 134 ECT patients. The mean age was 33.6±10.48 years. Anesthesia induction was provided with propofol one mg kg-intravenously (IV) followed by succinylcholine 0.5 mg kg^-1 IV (n=68) (Group S) or rocuronium 0.3 mg kg^-1 IV (n=66) (Group R). For patients who were given rocuronium, reversal of the residual neuromuscular block was accomplished with sugammadex (1.5 mg kg^-1 IV). First session seizure variables were compared between the two groups. We also presented the clinical outcome with Clinical Global Impression-Improvement (CGI-I) and overall adverse effects.
Results
EEG seizure durations in Group R (55.09±36.11 s) and Group S (47.00±26.33 s) were comparable and were not significantly different (p=0.432). The clinical efficacy of ECT measured by CGI-I in both groups was comparable (p=0.075). There were no major complications or death during or after ECT.
Conclusion
The results of this study show that the use of rocuronium-sugammadex as a neuromuscular blocker instead of succinylcholine during ECT with propofol anesthesia produces similar results in terms of seizure variables and clinical outcomes.

Keyword

Electroconvulsive therapy; Rocuronium; Sugammadex; Succinylcholine; Seizure