title: Use of rocuronium-sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy.
abstract: We compared the recovery time from neuromuscular blockade induced by rocuronium combined with sugammadex versus succinylcholine during electroconvulsive therapy (ECT). Anesthesia was induced using propofol, followed by succinylcholine (1 mg/kg) or rocuronium (0.6 mg/kg). Immediately after the seizure stopped, 16 mg/kg sugammadex was infused. Neuromuscular monitoring was performed and continued until recovery of the train-of-four ratio to 0.9. We compared the recovery time of T1 to 10 and 90% between groups. Patients were also assessed for clinical signs, such as time to first spontaneous breath from the administration of muscle relaxant and eye opening to verbal commands. Although recovery time of T1 to 10 and 90% in the rocuronium-sugammadex group was shorter than in the succinylcholine group, the difference was not statistically significant. Further, the seizure duration with succinylcholine (33 ± 8 s) was shorter than that with rocuronium-sugammadex (39 ± 4 s). In conclusion, this study demonstrates the potential benefit of use of rocuronium-sugammadex as an alternative to succinylcholine for muscle relaxation during ECT.
authors.affiliation: Department of Anesthesiology, Gunma University, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Hoshi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kadoi
authors.forename: Jiro
authors.initials: J
authors.lastname: Kamiyama
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Saito
authors.forename: Masaki
authors.initials: M
authors.lastname: Taguchi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000368:Aged; D000732:Androstanols / Q000494:pharmacology*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology*; D000077123:Rocuronium; D013390:Succinylcholine / Q000494:pharmacology*; D000077122:Sugammadex; D013997:Time Factors; D047408:gamma-Cyclodextrins / Q000494:pharmacology*
chemical_list: D000732:Androstanols; D009466:Neuromuscular Blocking Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D013390:Succinylcholine; D000077123:Rocuronium