Acute hemodynamic responses to electroconvulsive therapy are not related to the duration of seizure activity

Wen Fu, Louis A. Stool, Paul F. White, Mustafa M. Husain

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Study 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 (IV) lidocaine. Design: Randomized, double-blind, placebo- controlled, cross-over study. Setting: University-affiliated hospital. Patients: 21 ASA physical statues I, II, and III patients undergoing four consecutive maintenance ECT treatments for chronic depression. Interventions: Patients received lidocaine 50 mg, 100 mg, 200 mg IV, or saline prior to induction of anesthesia via a standardized anesthetic technique. Measurements and Main 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.

Original languageEnglish (US)
Pages (from-to)653-657
Number of pages5
JournalJournal of Clinical Anesthesia
Volume9
Issue number8
DOIs
StatePublished - Dec 1997

Fingerprint

Electroconvulsive Therapy
Lidocaine
Seizures
Hemodynamics
Heart Rate
Blood Pressure
Cross-Over Studies
Anesthetics
Anesthesia
Placebos
Maintenance
Depression
Therapeutics

Keywords

  • Anesthetics, local: lidocaine
  • Electroconvulsive therapy
  • Electroencephalography: seizure activity
  • Hypertension

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Acute hemodynamic responses to electroconvulsive therapy are not related to the duration of seizure activity. / Fu, Wen; Stool, Louis A.; White, Paul F.; Husain, Mustafa M.

In: Journal of Clinical Anesthesia, Vol. 9, No. 8, 12.1997, p. 653-657.

Research output: Contribution to journalArticle

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AB - Study 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 (IV) lidocaine. Design: Randomized, double-blind, placebo- controlled, cross-over study. Setting: University-affiliated hospital. Patients: 21 ASA physical statues I, II, and III patients undergoing four consecutive maintenance ECT treatments for chronic depression. Interventions: Patients received lidocaine 50 mg, 100 mg, 200 mg IV, or saline prior to induction of anesthesia via a standardized anesthetic technique. Measurements and Main 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.

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