N/A
N=45
Optimal Dose of Succinylcholine and Rocuronium for Electroconvulsive Therapy (ECT)
Neuromuscular Blockade · ECT
Bottom Line
View on ClinicalTrials.gov: NCT01441960 ↗Enrolled (actual)
45
Serious AEs
0.0%
Results posted
Jun 2015
Primary outcome: Primary: Optimal Dose of Neuromuscular Blocking Agent During ECT — 0.85; 0.41 mg.kg-1
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Succinylcholine (Drug); Rocuronium (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Massachusetts General Hospital
- Primary completion
- Jul 2013
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Optimal Dose of Neuromuscular Blocking Agent During ECT |
0.85; 0.41 | — |
| SECONDARY Compound Specific Differences in Time to Recovery From Neuromuscular Blockade |
9.7; 19.5 | — |
| SECONDARY Differences in Seizure Duration Between Compounds |
27; 31 | — |
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.
Eligibility 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
Data sourced from ClinicalTrials.gov (NCT01441960). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.