TY - JOUR
T1 - The use of nicardipine for electroconvulsive therapy
T2 - A dose-ranging study
AU - Zhang, Yunan
AU - White, Paul F.
AU - Thornton, Larry
AU - Perdue, Lisa
AU - Downing, Michael
PY - 2005/2
Y1 - 2005/2
N2 - A wide variety of vasoactive drugs have been used to treat the acute hypertensive response to electroconvulsive therapy (ECT). We designed this randomized, double-blind, saline-controlled, crossover study to compare three different doses of nicardipine when administered before the ECT stimulus. Twenty-five patients undergoing a series of 4 ECT treatments received bolus injections of either saline or nicardipine 20,40, or 80 μg/kg IV in a random sequence during a standardized methohexital (1 mg/kg) and succinylcholine (1 mg/kg) anesthetic technique. The mean arterial blood pressure (MAP) and heart rate values were recorded at specific time intervals, as were the duration of seizure activity and the need for rescue labetalol. Both the 40 and 80 μg/kg doses of nicardipine reduced the percentage increase in MAP above the baseline value compared with the saline group (7% and 7% versus 30%, respectively). Nicardipine 40 and 80 μg/kg were also associated with a significant reduction in the need for labetalol (7 ± 3 mg and 5 ± 0 mg versus 22 ± 10 mg in the saline group). Compared with the 40 μg/kg dose, nicardipine 80 μg/kg was associated with a more rapid heart rate at the time the ECT stimulus was applied. The 80 μg/kg dose was also associated with a reduced MAP value on awakening compared with the baseline value (91 ± 12 mm Hg versus 102 ± 8 mm Hg). We conclude that a bolus injection of nicardipine 40 μg/kg IV immediately before the ECT stimulus was optimal for controlling the acute hemodynamic response to ECT treatments.
AB - A wide variety of vasoactive drugs have been used to treat the acute hypertensive response to electroconvulsive therapy (ECT). We designed this randomized, double-blind, saline-controlled, crossover study to compare three different doses of nicardipine when administered before the ECT stimulus. Twenty-five patients undergoing a series of 4 ECT treatments received bolus injections of either saline or nicardipine 20,40, or 80 μg/kg IV in a random sequence during a standardized methohexital (1 mg/kg) and succinylcholine (1 mg/kg) anesthetic technique. The mean arterial blood pressure (MAP) and heart rate values were recorded at specific time intervals, as were the duration of seizure activity and the need for rescue labetalol. Both the 40 and 80 μg/kg doses of nicardipine reduced the percentage increase in MAP above the baseline value compared with the saline group (7% and 7% versus 30%, respectively). Nicardipine 40 and 80 μg/kg were also associated with a significant reduction in the need for labetalol (7 ± 3 mg and 5 ± 0 mg versus 22 ± 10 mg in the saline group). Compared with the 40 μg/kg dose, nicardipine 80 μg/kg was associated with a more rapid heart rate at the time the ECT stimulus was applied. The 80 μg/kg dose was also associated with a reduced MAP value on awakening compared with the baseline value (91 ± 12 mm Hg versus 102 ± 8 mm Hg). We conclude that a bolus injection of nicardipine 40 μg/kg IV immediately before the ECT stimulus was optimal for controlling the acute hemodynamic response to ECT treatments.
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U2 - 10.1213/01.ANE.0000144419.44481.59
DO - 10.1213/01.ANE.0000144419.44481.59
M3 - Article
C2 - 15673861
AN - SCOPUS:12844251300
SN - 0003-2999
VL - 100
SP - 378
EP - 381
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 2
ER -