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Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
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Remimazolam Anesthesia for Modified Electroconvulsive Therapy Mitigates Postoperative Agitation

Shinako Shimono1, Tomoharu Shakuo2, Aya Yamamura2

  • 1Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, JPN.

Cureus
|November 11, 2024
PubMed

Insights

Remimazolam may reduce postoperative agitation after modified electroconvulsive therapy (mECT). This case study shows effective convulsions and calm arousal with remimazolam, suggesting potential benefits for patients with a history of agitation.

Area of Science:

  • Anesthesiology
  • Neuroscience
  • Psychiatry

Background:

  • Modified electroconvulsive therapy (mECT) is associated with postoperative complications like agitation and delirium.
  • Remimazolam, an ultra-short-acting benzodiazepine, has shown potential in reducing postoperative delirium.
  • No previous reports exist on remimazolam's use in mECT.

Observation:

  • A 45-year-old male patient with severe depression and psychotic symptoms underwent mECT.
  • Due to prior agitation post-awakening, remimazolam and suxamethonium were administered for anesthesia.
  • The patient experienced effective convulsions and a calm awakening without agitation.

Findings:

  • Remimazolam facilitated effective convulsions during mECT.
  • Remimazolam administration suppressed postoperative excitation and agitation.
  • Intraoperative vital signs remained stable throughout the procedure.

Implications:

  • Remimazolam appears effective for anesthesia induction in mECT, promoting calm arousal.
  • Further research is needed to clarify remimazolam's specific role in seizure induction during mECT.
  • This case highlights a potential strategy for managing agitation in mECT patients.
Keywords:
anesthesiologybenzodiazepinesdepressionmodified-electroconvulsive therapypostoperative agitationpropofolremimazolam

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