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Rocuronium-Sugammadex in Anesthesia for Electroconvulsive Therapy

Year 2016, Volume: 8 Issue: 1, 76 - 84, 23.01.2016
https://doi.org/10.18863/pgy.91843

Abstract

Electroconvulsive therapy (ECT) is a form of treatment which is very effective in many psychiatric disorders. The administration of anesthesia plays a positive role in the success of ECT and improves the oxygenation of the body during the process. Succinylcholine, is a depolarizing neuromuscular blocker of choice, the most common agent used to provide muscular relaxation during ECT. Alternative neuromusculer blokers have been used during anesthesia because of contraindications and serious side effects of succinylcholine. Rocuronium is a nondepolarizing neuromuscular blocker with intermediate time of action which may be used safely during ECT. Although relatively late onset of action and long half life compared to succinylcholine may seem as drawbacks, the new generation reversing agents like suggamadex have made these disadvantages ignorable. Sugammadex, a new generation neuromuscular blocker reversal agent, not having serious side effects as much as the classic reversals, such as cardiovascular side effects, is playing an important role in anesthesiology practice. In recent years, rocuronium - sugammadex combination is being included in the ECT practice extensively. In this paper, the usability of rocuronium-sugammadex combination as an alternative to succinylcholine has been revised.

References

  • Algül A, Şen H, Ateş MA, Yen T, Durmaz O, Özkan S et al. (2009) Elektrokonvülzif tedavide propofol ile propofol remifentanil kombinasyonun nöbet süresi ve hemodinami üzerine etkisi. Klinik Psikofarmakoloji Bülteni,19:24-28.
  • Başgül E, Çeliker V (2004) Elektrokonvulsif tedavide anestezi yaklaşımı. Turk Psikiyatri Derg, 15:225-235.
  • Batistaki C, Kesidis K, Apostolaki S, Kostopanagiotou G (2011) Rocuronium antagonized by sugammadex for series of electroconvulsive therapy (ECT) in a patient with pseudocholinesterase deficiency. J ECT, 27:e47-e48.
  • Bom A, Hope F, Rutherford S, Thomson K (2009) Preclinical pharmacology of sugammadex. J Crit Care, 24:29-35.
  • Brull SJ, Naguib M (2009) Selective reversal of muscle relaxation in general anesthesia: focus on sugammadex. Drug Des Devel Ther, 3:119-129.
  • Calarge CA, Crowe RR, Gergis SD, Arndt S, From RP (2003) The comparative effects of sevoflurane and methohexital for electroconvulsive therapy. J ECT, 19:221-215.
  • Cammu G, de Kam PJ, De Graeve K, van den Heuvel M, Suy K, Morias K et al. (2010) Repeat dosing of rocuronium 1.2 mg kg-1 after reversal of neuromuscular block by sugammadex 4.0 mg kg-1 in anaesthetized healthy volunteers: a modelling-based pilot study. Br J Anaesth, 105:487-492.
  • Canbek O, Ipekcoglu D, Menges OO, Atagun MI, Karamustafaloglu N, Cetinkaya OZ et al. (2015) Comparison of propofol, etomidate, and thiopental in anesthesia for electroconvulsive therapy: a randomized, double-blind clinical trial. J ECT, 31:91- 97.
  • Chanpattana W (2001) Anesthesia for ECT. German J Psychiatry, 4:33-39.
  • de Boer HD, van Esmond J, Booij LH, Driessen JJ (2009) Reversal of rocuronium-induced profound neuromuscular block by sugammadex in Duchenne muscular dystrophy. Pediatric Anesthesia 19: 1226-1128.
  • Ding Z, White PF (2002) Anesthesia for electroconvulsive therapy. Anesth Analg, 94:1351-1364.
  • Fields AM, Vadivelu N (2007) Sugammadex: a novel neuromuscular blocker binding agent. Curr Opin Anaesthesiol, 20:307-310.
  • Gaines GY 3rd, Rees DI (1992) Anesthetic considerations for electroconvulsive therapy. South Med J, 85:469-482.
  • Hemmerling TM, Zaouter C, Geldner G, Nauheimer D (2010) Sugammadex-a short review and clinical recommendations for the cardiac anesthesiologist. Ann Card Anaesth, 13:206-216.
  • Hodgson RE, Dawson P, Hold AR, Rout CC, Zuma K (2004) Anaesthesia for electroconvulsive therapy: a comparison of sevoflurane with propofol. Anaesth Intensive Care, 32:241-245.
  • Hoshi H, Kadoi Y, Kamiyama J, Nishida A, Saito H, Taguchi M et al. (2011) Use of rocuronium-sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy. J Anesth. 25:286-290.
  • İyilikçi L, İkiz C, Adıyaman E, Gökel E, Günerli A (2013)Ameliyathane dışı anestezi: gebe hastalarda deneyimlerimiz (10 olgu). Turk J Anaesth Reanim, 41:65-67.
  • Kadoi Y, Hoshi H, Nishida A, Saito S (2011) Comparison of recovery times from rocuronium-induced muscle relaxation after reversal with three different doses of sugammadex and succinylcholine during electroconvulsive therapy. J Anesth, 25:855- 859.
  • Kısa C, Okay T, Dilbaz N (2001) Anestezi ve kas gevşeticili modifiye elektrokonvülzif tedavi uygulamaları. Klinik Psikiyatri Dergisi, 4:253-260.
  • Konishi J, Suzuki T, Kondo Y, Baba M, Ogawa S (2012) Rocuronium and sugammadex used effectively for electroconvulsive therapy in a patient with Brugada syndrome. J ECT, 28:e21-e22.
  • Lee C, Jahr JS, Candiotti KA, Warriner B, Zornow MH, Naguib M (2009) Reversal of profound neuromuscular block by sugammadex administered three minutes after rocuronium: a comparison with spontaneous recovery from succinylcholine. Anesthesiology, 110:1020-1025.
  • Lemmens HJ, El-Orbany MI, Berry J, Morte JB Jr, Martin G (2010) Reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia: sugammadex versus neostigmine. BMC Anesthesiol, 10:15.
  • Mayo C, Kaye AD, Conrad E, Baluch A, Frost E (2010) Update on anesthesia considerations for electroconvulsive therapy. Middle East J Anaesthesiol, 20:493-8.
  • McTernan CN, Rapeport DA, Ledowski T (2010) Successful use of rocuronium and sugammadex in an anticipated difficult airway scenario. Anaesth Intensive Care, 38:390-392.
  • Miller RD (2010) Miller Anestezi (Çeviri Ed. D Aydın). İzmir Güven Kitabevi.
  • Mirzakhani H, Welch CA, Eikermann M, Nozari A (2012) Neuromuscular blocking agents for electroconvulsive therapy: a systematic review. Acta Anaesthesiol Scand, 56:3-16.
  • Nordanskog P, Dahlstrand U, Larsson MR, Larsson EM, Knutsson L, Johanson A (2010) Increase in hippocampal volume after electroconvulsive therapy in patients with depression: a volumetric magnetic resonance imaging study. J ECT, 26:62-67.
  • Öksüz H, Doğan Z, Orhan FÖ (2009) Yüksek enerji düzeyi gereken elektrokonvülzif tedavilerde anestezik seçimin önemi: olgu sunumu eşliğinde etomidat kullanımı. Erciyes Tıp Dergisi, 31:276-281.
  • Postacı A, Tiryaki C, Saçan O, Örnek D, Kalyoncu M, Dikmen B (2013) Rocuronium-sugammadex decreases the severity of post- electroconvulsive therapy agitation. J ECT, 29:e2-e3.
  • Rasmussen KG, Laurila DR, Brady BM, Lewis CL, Niemeyer KD, Sun NM et al. (2007) Anesthesia outcomes in a randomized double- blind trial of sevoflurane and thiopental for induction of general anesthesia in electroconvulsive therapy. J ECT, 23:236-238.
  • Rasmussen KG, Spackman TN, Hooten WM (2005) The clinical utility of inhalational anesthesia with sevoflurane in electroconvulsive therapy. J ECT, 21:239-242.
  • Sarıçiçek V, Şahin L, Bülbül F, Uçar S, Şahin M (2014) Does rocuronium-sugammadex reduce myalgia and headache after electroconvulsive therapy in patients with major depression? J ECT, 30:30-34.
  • Sedighinejad A, Nabi BN, Haghighi M, Farzam A, Sayyah Z, Kabiri M et al. (2015) Electroconvulsive therapy-related cognitive impairment and choice of anesthesia: the tipping point. J ECT, 31:101-104.
  • Turkkal DC, Gokmen N, Yildiz A, Iyilikci L, Gokel E, Sagduyu K et al. (2008) A cross-over, post-electroconvulsive therapy comparison of clinical recovery from rocuronium versus succinylcholine. J Clin Anesth, 20:589-593.
  • Uppal V, Dourish J, Macfarlane A (2010) Anaesthesia for electroconvulsive therapy. Continuing Education in Anaesthesia, Critical Care & Pain, doi:10.1093/bjaceaccp/mkq039.
  • Zeren T, Tamam L, Evlice YE (2003) Elektrokonvulzif terapi: bir genel değerlendirme. Arşiv Kaynak Tarama Dergisi, 12:340-376. Nilay Taş, Yrd.Doç.Dr., Ordu Üniversitesi,Ordu; Esra Yancar Demir, Yrd.Doç.Dr., Ordu Üniversitesi, Ordu.

Elektrokonvulsif Tedavi Anestezisinde Rokuronyum-Sugammadeks

Year 2016, Volume: 8 Issue: 1, 76 - 84, 23.01.2016
https://doi.org/10.18863/pgy.91843

Abstract

Elektrokonvulsif tedavi (EKT), pek çok psikiyatrik bozuklukta etkili olan bir tedavi biçimidir. Anestezi uygulaması, hem EKT’nin başarılı olmasında rol oynar hem de işlem sırasında vücudun oksijen kullanımını iyileştirir. Süksinilkolin, EKT sırasında kas gevşekliği sağlamak için en sık kullanılan depolarizan özellikte nöromuskuler blokerdir. Süksinilkolinin ciddi yan etkilere sahip olması ve kontrendike olduğu durumlar sebebiyle, anestezi uygulaması için alternatif nöromuskuler blokerler kullanıma girmiştir. Rokuronyum, orta etki süreli nondepolarizan bir nöromuskuler bloker olup EKT sırasında güvenle kullanılmaktadır. Sugammadeks, bazı nondepolarizan nöromuskuler blokerlerin etkisinin sonlandırılması amacıyla kullanılan yeni nesil bir geri döndürücü ajandır. Geleneksel geri döndürücü ajanların meydana getirdiği kardiyovasküler yan etkiler gibi bir takım yan etkilerinin olmaması sebebiyle anestezi pratiğinde önemli bir yere sahip olmuştur. Rokronyum–sugammadeks  kombinasyonu gün geçtikçe daha fazla oranda EKT sırasında kullanılmaktadır. Bu derlemede, EKT anestezisinde süksinilkoline alternatif olarak rokuronyum–sugammadeks kombinasyonunun kullanılabilirliği gözden geçirilmiştir.

References

  • Algül A, Şen H, Ateş MA, Yen T, Durmaz O, Özkan S et al. (2009) Elektrokonvülzif tedavide propofol ile propofol remifentanil kombinasyonun nöbet süresi ve hemodinami üzerine etkisi. Klinik Psikofarmakoloji Bülteni,19:24-28.
  • Başgül E, Çeliker V (2004) Elektrokonvulsif tedavide anestezi yaklaşımı. Turk Psikiyatri Derg, 15:225-235.
  • Batistaki C, Kesidis K, Apostolaki S, Kostopanagiotou G (2011) Rocuronium antagonized by sugammadex for series of electroconvulsive therapy (ECT) in a patient with pseudocholinesterase deficiency. J ECT, 27:e47-e48.
  • Bom A, Hope F, Rutherford S, Thomson K (2009) Preclinical pharmacology of sugammadex. J Crit Care, 24:29-35.
  • Brull SJ, Naguib M (2009) Selective reversal of muscle relaxation in general anesthesia: focus on sugammadex. Drug Des Devel Ther, 3:119-129.
  • Calarge CA, Crowe RR, Gergis SD, Arndt S, From RP (2003) The comparative effects of sevoflurane and methohexital for electroconvulsive therapy. J ECT, 19:221-215.
  • Cammu G, de Kam PJ, De Graeve K, van den Heuvel M, Suy K, Morias K et al. (2010) Repeat dosing of rocuronium 1.2 mg kg-1 after reversal of neuromuscular block by sugammadex 4.0 mg kg-1 in anaesthetized healthy volunteers: a modelling-based pilot study. Br J Anaesth, 105:487-492.
  • Canbek O, Ipekcoglu D, Menges OO, Atagun MI, Karamustafaloglu N, Cetinkaya OZ et al. (2015) Comparison of propofol, etomidate, and thiopental in anesthesia for electroconvulsive therapy: a randomized, double-blind clinical trial. J ECT, 31:91- 97.
  • Chanpattana W (2001) Anesthesia for ECT. German J Psychiatry, 4:33-39.
  • de Boer HD, van Esmond J, Booij LH, Driessen JJ (2009) Reversal of rocuronium-induced profound neuromuscular block by sugammadex in Duchenne muscular dystrophy. Pediatric Anesthesia 19: 1226-1128.
  • Ding Z, White PF (2002) Anesthesia for electroconvulsive therapy. Anesth Analg, 94:1351-1364.
  • Fields AM, Vadivelu N (2007) Sugammadex: a novel neuromuscular blocker binding agent. Curr Opin Anaesthesiol, 20:307-310.
  • Gaines GY 3rd, Rees DI (1992) Anesthetic considerations for electroconvulsive therapy. South Med J, 85:469-482.
  • Hemmerling TM, Zaouter C, Geldner G, Nauheimer D (2010) Sugammadex-a short review and clinical recommendations for the cardiac anesthesiologist. Ann Card Anaesth, 13:206-216.
  • Hodgson RE, Dawson P, Hold AR, Rout CC, Zuma K (2004) Anaesthesia for electroconvulsive therapy: a comparison of sevoflurane with propofol. Anaesth Intensive Care, 32:241-245.
  • Hoshi H, Kadoi Y, Kamiyama J, Nishida A, Saito H, Taguchi M et al. (2011) Use of rocuronium-sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy. J Anesth. 25:286-290.
  • İyilikçi L, İkiz C, Adıyaman E, Gökel E, Günerli A (2013)Ameliyathane dışı anestezi: gebe hastalarda deneyimlerimiz (10 olgu). Turk J Anaesth Reanim, 41:65-67.
  • Kadoi Y, Hoshi H, Nishida A, Saito S (2011) Comparison of recovery times from rocuronium-induced muscle relaxation after reversal with three different doses of sugammadex and succinylcholine during electroconvulsive therapy. J Anesth, 25:855- 859.
  • Kısa C, Okay T, Dilbaz N (2001) Anestezi ve kas gevşeticili modifiye elektrokonvülzif tedavi uygulamaları. Klinik Psikiyatri Dergisi, 4:253-260.
  • Konishi J, Suzuki T, Kondo Y, Baba M, Ogawa S (2012) Rocuronium and sugammadex used effectively for electroconvulsive therapy in a patient with Brugada syndrome. J ECT, 28:e21-e22.
  • Lee C, Jahr JS, Candiotti KA, Warriner B, Zornow MH, Naguib M (2009) Reversal of profound neuromuscular block by sugammadex administered three minutes after rocuronium: a comparison with spontaneous recovery from succinylcholine. Anesthesiology, 110:1020-1025.
  • Lemmens HJ, El-Orbany MI, Berry J, Morte JB Jr, Martin G (2010) Reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia: sugammadex versus neostigmine. BMC Anesthesiol, 10:15.
  • Mayo C, Kaye AD, Conrad E, Baluch A, Frost E (2010) Update on anesthesia considerations for electroconvulsive therapy. Middle East J Anaesthesiol, 20:493-8.
  • McTernan CN, Rapeport DA, Ledowski T (2010) Successful use of rocuronium and sugammadex in an anticipated difficult airway scenario. Anaesth Intensive Care, 38:390-392.
  • Miller RD (2010) Miller Anestezi (Çeviri Ed. D Aydın). İzmir Güven Kitabevi.
  • Mirzakhani H, Welch CA, Eikermann M, Nozari A (2012) Neuromuscular blocking agents for electroconvulsive therapy: a systematic review. Acta Anaesthesiol Scand, 56:3-16.
  • Nordanskog P, Dahlstrand U, Larsson MR, Larsson EM, Knutsson L, Johanson A (2010) Increase in hippocampal volume after electroconvulsive therapy in patients with depression: a volumetric magnetic resonance imaging study. J ECT, 26:62-67.
  • Öksüz H, Doğan Z, Orhan FÖ (2009) Yüksek enerji düzeyi gereken elektrokonvülzif tedavilerde anestezik seçimin önemi: olgu sunumu eşliğinde etomidat kullanımı. Erciyes Tıp Dergisi, 31:276-281.
  • Postacı A, Tiryaki C, Saçan O, Örnek D, Kalyoncu M, Dikmen B (2013) Rocuronium-sugammadex decreases the severity of post- electroconvulsive therapy agitation. J ECT, 29:e2-e3.
  • Rasmussen KG, Laurila DR, Brady BM, Lewis CL, Niemeyer KD, Sun NM et al. (2007) Anesthesia outcomes in a randomized double- blind trial of sevoflurane and thiopental for induction of general anesthesia in electroconvulsive therapy. J ECT, 23:236-238.
  • Rasmussen KG, Spackman TN, Hooten WM (2005) The clinical utility of inhalational anesthesia with sevoflurane in electroconvulsive therapy. J ECT, 21:239-242.
  • Sarıçiçek V, Şahin L, Bülbül F, Uçar S, Şahin M (2014) Does rocuronium-sugammadex reduce myalgia and headache after electroconvulsive therapy in patients with major depression? J ECT, 30:30-34.
  • Sedighinejad A, Nabi BN, Haghighi M, Farzam A, Sayyah Z, Kabiri M et al. (2015) Electroconvulsive therapy-related cognitive impairment and choice of anesthesia: the tipping point. J ECT, 31:101-104.
  • Turkkal DC, Gokmen N, Yildiz A, Iyilikci L, Gokel E, Sagduyu K et al. (2008) A cross-over, post-electroconvulsive therapy comparison of clinical recovery from rocuronium versus succinylcholine. J Clin Anesth, 20:589-593.
  • Uppal V, Dourish J, Macfarlane A (2010) Anaesthesia for electroconvulsive therapy. Continuing Education in Anaesthesia, Critical Care & Pain, doi:10.1093/bjaceaccp/mkq039.
  • Zeren T, Tamam L, Evlice YE (2003) Elektrokonvulzif terapi: bir genel değerlendirme. Arşiv Kaynak Tarama Dergisi, 12:340-376. Nilay Taş, Yrd.Doç.Dr., Ordu Üniversitesi,Ordu; Esra Yancar Demir, Yrd.Doç.Dr., Ordu Üniversitesi, Ordu.
There are 36 citations in total.

Details

Primary Language English
Journal Section Review
Authors

Nilay Taş

Esra Yancar Demir This is me

Publication Date January 23, 2016
Published in Issue Year 2016 Volume: 8 Issue: 1

Cite

AMA Taş N, Yancar Demir E. Rocuronium-Sugammadex in Anesthesia for Electroconvulsive Therapy. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. January 2016;8(1):76-84. doi:10.18863/pgy.91843

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