Optimal Dose of Succinylcholine and Rocuronium for Electroconvulsive Therapy (ECT)

• Status: Completed
• Trial end date: 2015-02-01
• Target enrollment: 0
• Participant gender: All

Summary

Electroconvulsive therapy (ECT) is the transcutaneous application of small electrical stimuli to the brain to produce generalized seizures for the treatment of selected psychiatric disorders such as severe depression. The aim of ECT is to induce a therapeutic tonic seizure where the person loses consciousness and has convulsions. Patients need general anesthesia and neuromuscular blockade to treat pain and avoid excessive tonic clonic motor contraction that might be associated with compression fractures. Neuromuscular blocking drugs (NMBD) are, therefore, administered after induction of general anesthesia to induce neuromuscular blockade. Despite the importance of NMBDs to provide optimal conditions for ECT treatment, the optimal NMBD dose to achieve acceptable neuromuscular blockade without excessive or untoward effects has not previously been identified in any study and in a prospective randomized fashion. The aim of this study is, therefore, to identify the optimal NMBD dose of two commonly used neuromuscular blocking agents (succinylcholine and rocuronium) in order to optimize the muscle strength modulation during ECT that facilitates ECT with the minimal side effects.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Massachusetts General Hospital
• Treatments: Rocuronium; Succinylcholine

Criteria

Inclusion Criteria:

• Adult patients (age 18-80) scheduled for ECT treatment at the MGH

Exclusion Criteria:

• Contraindication to the use of neuromuscular blocking drugs (e.g. allergy, preexisting muscular disease, and history of malignant hyperthermia)

• Malnutrition, general weakness

• Neurological or neuromuscular disease, including paralysis

• Liver disease with liver function test 2x greater than upper normal limit

• Kidney disease with eGFR<60

• Electrolyte abnormalities with values outside of the normal range

• Pregnancy

• Cardiac disease or abnormal EKG

• Medications that affect seizure threshold or blood pressure response

• Unwilling to participate in the study