90687
document
Effect of esmolol pretreatment on EEG seizure morphology in RUL ECT . Intravenous beta-blockers are an effective means of controlling heart rate and blood pressure during electroconvulsive therapy ( ECT ) , but have been shown to decrease seizure duration . While the importance of seizure duration to the antidepressant response of ECT grows less certain , there is growing evidence that seizure morphology predicts the antidepressant effect of ECT . This study examined the impact of esmolol pretreatment on seizure morphology . Eighteen depressed patients ( 6 men , 12 women ; 69 +/- 12.8 years old ) received ECT with and without esmolol pretreatment in a randomized , blinded crossover design . The seizures were blindly rated for duration of motor convulsion , duration of electroencephalogram ( EEG ) seizure , degree of seizure regularity , and degree of postictal EEG suppression . Esmolol shortened the duration of the motor convulsion and degraded the quality of the ictal regularity . Routine administration of intravenous esmolol before ECT may cause a decrease in ictal regularity . Careful consideration should be given to the potential benefits of esmolol versus the deleterious effect on the electrophysiologic process . Esmolol may still be indicated on a case-by-case basis for extreme tachycardia or hypertension associated with ECT , and presumably poses no problem for the therapeutic effect of ECT if given after the seizure is over .
90688
Intervention_Pharmacological
esmolol
90689
Intervention_Physical
electroconvulsive therapy ( ECT )
90690
Intervention_Pharmacological
esmolol
90691
Intervention_Physical
ECT
90692
Intervention_Pharmacological
with and without esmolol pretreatment
90693
Outcome_Physical
EEG seizure morphology
90694
Outcome_Physical
heart rate and blood pressure
90695
Outcome_Physical
seizure morphology .
90696
Outcome_Physical
duration of motor convulsion , duration of electroencephalogram ( EEG ) seizure , degree of seizure regularity , and degree of postictal EEG suppression .
90697
Outcome_Physical
quality of the ictal regularity .
90698
Participant_Sample-size
Eighteen
90699
Participant_Condition
depressed
90700
Participant_Sample-size
6
90701
Participant_Sex
men
90702
Participant_Sample-size
12
90703
Participant_Sex
women
90704
Participant_Age
69 +/- 12.8