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Related Experiment Video

Updated: Mar 23, 2026

Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
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Does remifentanil improve ECT seizure quality?

Verònica Gálvez1,2, Phern-Chern Tor3, Adriana Bassa1,2,4

  • 1School of Psychiatry, University of New South Wales (UNSW), Randwick, NSW, Australia.

European Archives of Psychiatry and Clinical Neuroscience
|April 3, 2016
PubMed
Summary
This summary is machine-generated.

This study found that remifentanil, when used as an adjuvant in electroconvulsive therapy (ECT), did not improve seizure quality or duration. The findings suggest remifentanil does not intrinsically enhance ECT seizures, contrary to some prior assumptions.

Keywords:
AnaesthesiaDurationEEGElectroconvulsive therapyRemifentanilSeizure

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Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
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Area of Science:

  • Neuroscience
  • Anesthesiology
  • Psychiatry

Background:

  • Electroconvulsive therapy (ECT) is a crucial treatment for severe mental health conditions.
  • Adjuvant medications are sometimes used to optimize ECT efficacy and tolerability.
  • Remifentanil's potential direct impact on ECT seizure quality, independent of anesthetic dose reduction, remains largely unexplored.

Purpose of the Study:

  • To investigate the direct effect of adjuvant remifentanil on electroconvulsive therapy (ECT) seizure quality.
  • To determine if remifentanil influences seizure parameters when conventional anesthetic doses are kept constant.
  • To assess the impact of remifentanil on specific seizure quality indices and duration.

Main Methods:

  • Retrospective analysis of 96 ECT sessions from 36 patients.
  • Comparison of ECT sessions with and without remifentanil (1 µg/kg) while maintaining consistent thiopentone or propofol dosage.
  • Assessment of seizure quality parameters (time to slow wave activity, amplitude, regularity, stereotypy, post-ictal suppression) and duration using a blinded rater.
  • Statistical analysis using linear mixed-effects models to account for individual patient variability.

Main Results:

  • Remifentanil was administered in 47.9% of the analyzed ECT sessions.
  • No statistically significant effect of adjuvant remifentanil was observed on any seizure quality parameters, including time to slow wave activity, amplitude, regularity, stereotypy, or post-ictal suppression.
  • Remifentanil did not significantly alter the duration of the ECT-induced seizures.

Conclusions:

  • Adjuvant remifentanil does not appear to possess intrinsic properties that enhance electroconvulsive therapy (ECT) seizure quality or duration.
  • While remifentanil might be useful for reducing anesthetic requirements in ECT, current evidence does not support its direct pro-convulsant effect.
  • Further research may be needed to fully elucidate the role of remifentanil in ECT, particularly concerning its interaction with anesthetic agents.