A cross-over, post-electroconvulsive therapy comparison of clinical recovery from rocuronium versus succinylcholine.
OBJECTIVE
To evaluate the effect of the neuromuscular blocking agent, rocuronium, on clinical recovery from electroconvulsive therapy (ECT) as compared with succinylcholine.


METHODS
Cross-over study.


METHODS
University hospital.


METHODS
13 ASA physical status I and II patients, ages 18 to 60 years, receiving ECT three times a week.


METHODS
Each patient received either succinylcholine before the first ECT session (Group S) and rocuronium before the third ECT session (Group R). Muscle paralysis was produced with succinylcholine one mg kg(-1) intravenously (IV) or rocuronium 0.3 mg kg(-1) IV. Reversal of the residual neuromuscular block (Group R) was accomplished with 10 microg kg(-1)of atropine and 20 microg kg(-1)of neostigmine after completion of the ECT procedure.


METHODS
Motor seizure duration time, time to first spontaneous breathing, eye opening, head lift, and tongue depressor test were recorded.


RESULTS
Motor seizure duration and time to first spontaneous breath was longer (33.6 sec vs. 24.2 sec; 9.46 min vs 8.07 min, respectively) in the rocuronium group than the succinylcholine group. No significant difference was detected between the two groups in eye opening, head lift, or tongue depressor testing.


CONCLUSIONS
Rocuronium, when used in conjunction with a reversal agent, may be an adequate alternative to succinylcholine as a neuromuscular blocker during ECT.
Turkkal
Deniz Cihan
DC
Department of Anesthesiology, Dokuz Eylül University School of Medicine, Inciralti, Izmir, Turkey.
Gokmen
Necati
N
Yildiz
Aysegul
A
Iyilikci
Leyla
L
Gokel
Erol
E
Sagduyu
Kemal
K
Gunerli
Ali
A
D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000627:therapeutic use*; D001285:Atropine / Q000627:therapeutic use; D018592:Cross-Over Studies; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000627:therapeutic use; D009467:Neuromuscular Depolarizing Agents / Q000627:therapeutic use*; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use*; D010276:Parasympatholytics / Q000627:therapeutic use; D010277:Parasympathomimetics / Q000627:therapeutic use; D000077123:Rocuronium; D013390:Succinylcholine / Q000627:therapeutic use*; D013997:Time Factors; D055815:Young Adult
D000732:Androstanols; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D010276:Parasympatholytics; D010277:Parasympathomimetics; D009388:Neostigmine; D001285:Atropine; D013390:Succinylcholine; D000077123:Rocuronium