Low dose mivacurium is less effective than succinylcholine in electroconvulsive therapy
To compare the efficacy of low dose (LD) mivacurium (0.08 mg.kg-1) with LD succinylcholine (0.5 mg.kg-1) in modifying seizure activity during electroconvulsive therapy (ECT). Partial muscle relaxation is used in ECT to prevent violent muscle contractions. Current practice is to use LD succinylcholin...
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| Veröffentlicht in: | Canadian journal of anesthesia 1999, Vol.46 (1), p.49-51 |
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| creator | CHEAM, E. W. S CRITCHLEY, L. A. H CHUI, P. T YAP, J. C. M HA, V. W. S |
| description | To compare the efficacy of low dose (LD) mivacurium (0.08 mg.kg-1) with LD succinylcholine (0.5 mg.kg-1) in modifying seizure activity during electroconvulsive therapy (ECT). Partial muscle relaxation is used in ECT to prevent violent muscle contractions. Current practice is to use LD succinylcholine which has several undesirable side effects.
Sixteen depressed, but otherwise healthy, patients, aged 27-67 yr were studied. In a randomized, double-blind, cross-over study, either LD mivacurium or LD succinylcholine was given at consecutive ECTs 120 and 30 sec respectively before inducing ECT. Neuromuscular blockade following mivacurium was not reversed. Seizure modification was scored--0 = no seizure activity, 1 = over-modified, 2 = desired level, 3 = under-modified, 4 = unmodified. Duration of seizures, time to first breath and adequate ventilation, ability to protrude tongue and sustain hand grip for five seconds were recorded. Paired t-tests and Wilcoxon matched pairs test were used to compare data. P < 0.05 was considered significant.
Seizure modification was better (mean (range)) after succinylcholine 2.06(1-3) than after mivacurium 2.56(2-4) (P < 0.05). Mivacurium was unsatisfactory in eight cases compared with two cases after succinylcholine. The study was terminated early because of unsatisfactory seizure control. Clinical assessments of recovery from both relaxants were similar.
Low dose mivacurium is unsuitable for use in ECT. |
| doi_str_mv | 10.1007/BF03012514 |
| format | Article |
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Sixteen depressed, but otherwise healthy, patients, aged 27-67 yr were studied. In a randomized, double-blind, cross-over study, either LD mivacurium or LD succinylcholine was given at consecutive ECTs 120 and 30 sec respectively before inducing ECT. Neuromuscular blockade following mivacurium was not reversed. Seizure modification was scored--0 = no seizure activity, 1 = over-modified, 2 = desired level, 3 = under-modified, 4 = unmodified. Duration of seizures, time to first breath and adequate ventilation, ability to protrude tongue and sustain hand grip for five seconds were recorded. Paired t-tests and Wilcoxon matched pairs test were used to compare data. P < 0.05 was considered significant.
Seizure modification was better (mean (range)) after succinylcholine 2.06(1-3) than after mivacurium 2.56(2-4) (P < 0.05). Mivacurium was unsatisfactory in eight cases compared with two cases after succinylcholine. The study was terminated early because of unsatisfactory seizure control. Clinical assessments of recovery from both relaxants were similar.
Low dose mivacurium is unsuitable for use in ECT.</description><identifier>ISSN: 0832-610X</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/BF03012514</identifier><identifier>PMID: 10078403</identifier><identifier>CODEN: CJOAEP</identifier><language>eng</language><publisher>Toronto, ON: Canadian Anesthesiologists' Society</publisher><subject>Adult ; Aged ; Anesthesia ; Anesthesia Recovery Period ; Anesthetics. Neuromuscular blocking agents ; Biological and medical sciences ; Cross-Over Studies ; Double-Blind Method ; Electroconvulsive Therapy ; Female ; Hand Strength - physiology ; Humans ; Isoquinolines - administration & dosage ; Male ; Medical sciences ; Middle Aged ; Muscle Contraction - drug effects ; Neuromuscular Blockade ; Neuromuscular Depolarizing Agents - administration & dosage ; Neuromuscular Nondepolarizing Agents - administration & dosage ; Neuropharmacology ; Patients ; Pharmacology. Drug treatments ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Respiration - drug effects ; Seizures - prevention & control ; Succinylcholine - administration & dosage ; Time Factors ; Tongue - drug effects ; Tongue - physiology ; Treatments ; Ventilators</subject><ispartof>Canadian journal of anesthesia, 1999, Vol.46 (1), p.49-51</ispartof><rights>1999 INIST-CNRS</rights><rights>Canadian Anesthesiologists 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-10f0e829d0ab5af6f31f9e204d8f6ffc78485ba63819bc486108e363348483813</citedby><cites>FETCH-LOGICAL-c375t-10f0e829d0ab5af6f31f9e204d8f6ffc78485ba63819bc486108e363348483813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1713914$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10078403$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CHEAM, E. W. S</creatorcontrib><creatorcontrib>CRITCHLEY, L. A. H</creatorcontrib><creatorcontrib>CHUI, P. T</creatorcontrib><creatorcontrib>YAP, J. C. M</creatorcontrib><creatorcontrib>HA, V. W. S</creatorcontrib><title>Low dose mivacurium is less effective than succinylcholine in electroconvulsive therapy</title><title>Canadian journal of anesthesia</title><addtitle>Can J Anaesth</addtitle><description>To compare the efficacy of low dose (LD) mivacurium (0.08 mg.kg-1) with LD succinylcholine (0.5 mg.kg-1) in modifying seizure activity during electroconvulsive therapy (ECT). Partial muscle relaxation is used in ECT to prevent violent muscle contractions. Current practice is to use LD succinylcholine which has several undesirable side effects.
Sixteen depressed, but otherwise healthy, patients, aged 27-67 yr were studied. In a randomized, double-blind, cross-over study, either LD mivacurium or LD succinylcholine was given at consecutive ECTs 120 and 30 sec respectively before inducing ECT. Neuromuscular blockade following mivacurium was not reversed. Seizure modification was scored--0 = no seizure activity, 1 = over-modified, 2 = desired level, 3 = under-modified, 4 = unmodified. Duration of seizures, time to first breath and adequate ventilation, ability to protrude tongue and sustain hand grip for five seconds were recorded. Paired t-tests and Wilcoxon matched pairs test were used to compare data. P < 0.05 was considered significant.
Seizure modification was better (mean (range)) after succinylcholine 2.06(1-3) than after mivacurium 2.56(2-4) (P < 0.05). Mivacurium was unsatisfactory in eight cases compared with two cases after succinylcholine. The study was terminated early because of unsatisfactory seizure control. Clinical assessments of recovery from both relaxants were similar.
Low dose mivacurium is unsuitable for use in ECT.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia Recovery Period</subject><subject>Anesthetics. Neuromuscular blocking agents</subject><subject>Biological and medical sciences</subject><subject>Cross-Over Studies</subject><subject>Double-Blind Method</subject><subject>Electroconvulsive Therapy</subject><subject>Female</subject><subject>Hand Strength - physiology</subject><subject>Humans</subject><subject>Isoquinolines - administration & dosage</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Muscle Contraction - drug effects</subject><subject>Neuromuscular Blockade</subject><subject>Neuromuscular Depolarizing Agents - administration & dosage</subject><subject>Neuromuscular Nondepolarizing Agents - administration & dosage</subject><subject>Neuropharmacology</subject><subject>Patients</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Respiration - drug effects</subject><subject>Seizures - prevention & control</subject><subject>Succinylcholine - administration & dosage</subject><subject>Time Factors</subject><subject>Tongue - drug effects</subject><subject>Tongue - physiology</subject><subject>Treatments</subject><subject>Ventilators</subject><issn>0832-610X</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpd0EFLwzAYBuAgipvTiz9AgogHoZo0bZoedTgVBl4UvZU0-8Iy0mYm7WT_3owOFE8hyZOXLy9C55TcUkKKu4cZYYSmOc0O0JhmJU9EWeSHaEwESxNOyecInYSwIoQInotjNNo9ExlhY_Qxd9944QLgxmyk6r3pG2wCthACBq1BdWYDuFvKFodeKdNurVo6a1rApsVgI_BOuXbT2zBI8HK9PUVHWtoAZ_t1gt5nj2_T52T--vQyvZ8nihV5l1CiCYi0XBBZ51JzzaguISXZQsSNVnFKkdeSM0HLWmUifkYA44xl8SIesgm6HnLX3n31ELqqMUGBtbIF14eKlzzllLEIL__Blet9G2erypRmeVFkeUQ3A1LeheBBV2tvGum3FSXVrrTqt-uIL_aJfd3A4g8dyo3gag9kUNJqL1tlwq8rKCtjzg_Xm4VZ</recordid><startdate>1999</startdate><enddate>1999</enddate><creator>CHEAM, E. W. S</creator><creator>CRITCHLEY, L. A. H</creator><creator>CHUI, P. T</creator><creator>YAP, J. C. M</creator><creator>HA, V. W. 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H ; CHUI, P. T ; YAP, J. C. M ; HA, V. W. S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-10f0e829d0ab5af6f31f9e204d8f6ffc78485ba63819bc486108e363348483813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia Recovery Period</topic><topic>Anesthetics. Neuromuscular blocking agents</topic><topic>Biological and medical sciences</topic><topic>Cross-Over Studies</topic><topic>Double-Blind Method</topic><topic>Electroconvulsive Therapy</topic><topic>Female</topic><topic>Hand Strength - physiology</topic><topic>Humans</topic><topic>Isoquinolines - administration & dosage</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Muscle Contraction - drug effects</topic><topic>Neuromuscular Blockade</topic><topic>Neuromuscular Depolarizing Agents - administration & dosage</topic><topic>Neuromuscular Nondepolarizing Agents - administration & dosage</topic><topic>Neuropharmacology</topic><topic>Patients</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Respiration - drug effects</topic><topic>Seizures - prevention & control</topic><topic>Succinylcholine - administration & dosage</topic><topic>Time Factors</topic><topic>Tongue - drug effects</topic><topic>Tongue - physiology</topic><topic>Treatments</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CHEAM, E. W. S</creatorcontrib><creatorcontrib>CRITCHLEY, L. A. H</creatorcontrib><creatorcontrib>CHUI, P. T</creatorcontrib><creatorcontrib>YAP, J. C. M</creatorcontrib><creatorcontrib>HA, V. W. 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W. S</au><au>CRITCHLEY, L. A. H</au><au>CHUI, P. T</au><au>YAP, J. C. M</au><au>HA, V. W. S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low dose mivacurium is less effective than succinylcholine in electroconvulsive therapy</atitle><jtitle>Canadian journal of anesthesia</jtitle><addtitle>Can J Anaesth</addtitle><date>1999</date><risdate>1999</risdate><volume>46</volume><issue>1</issue><spage>49</spage><epage>51</epage><pages>49-51</pages><issn>0832-610X</issn><eissn>1496-8975</eissn><coden>CJOAEP</coden><abstract>To compare the efficacy of low dose (LD) mivacurium (0.08 mg.kg-1) with LD succinylcholine (0.5 mg.kg-1) in modifying seizure activity during electroconvulsive therapy (ECT). Partial muscle relaxation is used in ECT to prevent violent muscle contractions. Current practice is to use LD succinylcholine which has several undesirable side effects.
Sixteen depressed, but otherwise healthy, patients, aged 27-67 yr were studied. In a randomized, double-blind, cross-over study, either LD mivacurium or LD succinylcholine was given at consecutive ECTs 120 and 30 sec respectively before inducing ECT. Neuromuscular blockade following mivacurium was not reversed. Seizure modification was scored--0 = no seizure activity, 1 = over-modified, 2 = desired level, 3 = under-modified, 4 = unmodified. Duration of seizures, time to first breath and adequate ventilation, ability to protrude tongue and sustain hand grip for five seconds were recorded. Paired t-tests and Wilcoxon matched pairs test were used to compare data. P < 0.05 was considered significant.
Seizure modification was better (mean (range)) after succinylcholine 2.06(1-3) than after mivacurium 2.56(2-4) (P < 0.05). Mivacurium was unsatisfactory in eight cases compared with two cases after succinylcholine. The study was terminated early because of unsatisfactory seizure control. Clinical assessments of recovery from both relaxants were similar.
Low dose mivacurium is unsuitable for use in ECT.</abstract><cop>Toronto, ON</cop><pub>Canadian Anesthesiologists' Society</pub><pmid>10078403</pmid><doi>10.1007/BF03012514</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Canadian journal of anesthesia, 1999, Vol.46 (1), p.49-51 |
| issn | 0832-610X 1496-8975 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Anesthesia Anesthesia Recovery Period Anesthetics. Neuromuscular blocking agents Biological and medical sciences Cross-Over Studies Double-Blind Method Electroconvulsive Therapy Female Hand Strength - physiology Humans Isoquinolines - administration & dosage Male Medical sciences Middle Aged Muscle Contraction - drug effects Neuromuscular Blockade Neuromuscular Depolarizing Agents - administration & dosage Neuromuscular Nondepolarizing Agents - administration & dosage Neuropharmacology Patients Pharmacology. Drug treatments Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Respiration - drug effects Seizures - prevention & control Succinylcholine - administration & dosage Time Factors Tongue - drug effects Tongue - physiology Treatments Ventilators |
| title | Low dose mivacurium is less effective than succinylcholine in electroconvulsive therapy |
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