Volume 6, Issue 2 (1-2016)                   JAP 2016, 6(2): 16-25 | Back to browse issues page


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Mohseni M, Khatibi A, Emami A, Ghambari A, Karimi B, Ghajar A. Effects of premedication with hyoscine , atropine and placebo on hemodynamic stability and recovery time in patients treated with electroconvulsive therapy. JAP. 2016; 6 (2) :16-25
URL: http://jap.iums.ac.ir/article-1-5216-en.html

1- Assistant Professor,Anesthesiology Department Iran University of Medical Science
2- Assistant Professor,Anesthesiology Department Iran University of Medical Science , alikhatibi2002@yahoo.com
3- Assistant Professor,Psycology Department Iran University of Medical Science
4- Resident of Anesthesiology Iran University of Medical Science
Abstract:   (1174 Views)

Abstract

Aims and Background: Electroconvulsive therapy (ECT) as a method of treatment in severe psychological disorders results in autonomic system stimulation and hemodynamic complications. To relieve these complications especially severe bradycardia and asystole, some authors usually   premedicate patients with anticholinergic drugs .The aim of this study was to determine and compare the effects of premedication with hyoscine, atropine and placebo on hemodynamic stability and recovery time in patients treated with electroconvulsive therapy.

Materials and Methods : Sixty patients scheduled for ECT were randomly allocated to 3 equal groups. Anesthesia method was the same among the three groups. Blood pressure and heart rate and any cardiac arrhythmias were recorded before, during and after ECT at predetermined intervals. Complications such as time interval to recovery, salivation volume, and any agitation upon recovery were recorded. These variables were compared between the three groups.

Findings: Tachycardia was significantly more prevalent in two groups pre-medicated with anticholinergics especially at two intervals in patients receiving hyoscine: after premedication and immediately after the shock(p<0.05).Arterial blood pressure was not significantly different among the groups. Severe bradycardia or asystole were not seen in any groups. Salivary secretions were significantly decreased in both atropine and hyoscine groups compared to placebo (p<0.003). There was no difference between 3 groups in regards to agitation, arrhythmia and recovery time.

Conclusion: Premedication with anticholinergics before ECT especially hyoscine butyl bromide potentiates tachycardia and decreases salivation but has no significant effect on agitation and recovery time. So we do not recommend routine anticholinergic administration before ECT to prevent any probable bradycardia or asystole.

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Type of Study: Applicable | Subject: Anesthesia pharmacology
Received: 2015.05.16 | Accepted: 2015.09.13 | Published: 2015.12.27

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