Acute hemodynamic responses to electroconvulsive therapy are not related to the duration of seizure activity.
OBJECTIVE
To test the hypothesis that the magnitude of the acute hemodynamic response to electroconvulsive therapy (ECT) is related to the duration of the seizure activity in patients receiving different dosages of intravenous (i.v.) lidocaine.


METHODS
Randomized, double-blind, placebo-controlled, cross-over study.


METHODS
University-affiliated hospital.


METHODS
21 ASA physical status I, II, and III patients undergoing four consecutive maintenance ECT treatments for chronic depression.


METHODS
Patients received lidocaine 50 mg, 100 mg, 200 mg i.v., or saline prior to induction of anesthesia via a standardized anesthetic technique.


RESULTS
Noninvasive blood pressure (BP) and heart rate (HR), as well as the duration of motor and electroencephalographic (EEG) seizure, were measured. The duration of motor and EEG seizures (means +/- SD) were 37 +/- 13 sec and 64 +/- 21 sec, 25 +/- 11 sec and 52 +/- 43 sec, 17 +/- 12 sec and 32 +/- 17 sec, 1 +/- 3 sec and 18 +/- 10 sec in the saline, lidocaine 50 mg, 100 mg, 200 mg groups, respectively. Although the duration of seizure activity was decreased in a dose-related fashion after lidocaine pretreatment, the peak increases in BP and HR were similar in the lidocaine and saline treatment groups.


CONCLUSIONS
Despite producing dose-related decreases in the duration of both motor and EEG seizure activity, lidocaine failed to attenuate the acute hemodynamic response to ECT. Thus, the acute hemodynamic response to ECT is not related to the duration of seizure activity.
Fu
W
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Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas 75235-9068, USA.
Stool
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White
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Husain
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D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D000779:Anesthetics, Local; D001794:Blood Pressure / Q000502:physiology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy; D004569:Electroencephalography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000503:physiopathology; D013997:Time Factors
D000779:Anesthetics, Local; D008012:Lidocaine