Related Experiment Videos
Esmolol bolus and infusion attenuates increases in blood pressure and heart rate during electroconvulsive therapy
1Department of Anesthesiology, University of Kansas Medical Center, Kansas City 66103.
Insights
A standardized dose of esmolol effectively blunted cardiovascular responses to electroconvulsive therapy (ECT). This beta-blocker reduced heart rate and blood pressure increases without affecting seizure duration or causing adverse events.
Area of Science:
- Anesthesiology
- Cardiology
- Neurology
Background:
- Electroconvulsive therapy (ECT) can induce significant cardiovascular responses.
- Managing these responses is crucial for patient safety during ECT.
Purpose of the Study:
- To evaluate the efficacy of a standardized esmolol dose in attenuating cardiovascular responses to ECT.
- To assess the safety and impact of esmolol on seizure duration during ECT.
Main Methods:
- A randomized, within-patient, crossover study involving 17 patients undergoing ECT.
- Patients received either esmolol (80 mg bolus + 24 mg/min infusion) or no esmolol prior to anesthesia induction.
- Cardiovascular parameters and seizure duration were compared between treatment groups.
Main Results:
- Esmolol significantly blunted maximum increases in heart rate (26%), mean arterial pressure (14%), and rate pressure product (37%).
- These effects were statistically significant (P<0.05) within minutes of ECT.
- No significant differences in seizure duration or adverse reactions were observed.
Conclusions:
- A standardized dose of esmolol is effective in mitigating the cardiovascular response to ECT.
- Esmolol appears to be a safe adjunct for ECT, without compromising therapeutic seizure duration.
Abstract:
To determine whether a standardized dose of esmolol can effectively attenuate the cardiovascular response to electroconvulsive therapy (ECT), 17 ASA physical status I-II patients were studied in a randomized within-patient, crossover design. Each patient received "no esmolol" during one ECT and three to five days later crossed over to the alternative treatment receiving an esmolol 80 mg bolus followed by 24 mg.min-1 infusion two minutes prior to induction of anaesthesia and continued for five minutes after induction. Esmolol blunted the maximum increases in heart rate (HR) by 26 per cent, mean arterial pressure (MAP) by 14 per cent, and rate pressure product by 37 per cent with significant differences (P less than 0.05) noted at one, two, three and four minutes after ECT (minutes five, six, seven, and eight of the esmolol infusion). There was no significant difference in seizure duration between the two groups and no adverse reactions occurred.