scholarly journals The Effects of Intravenous Lignocaine on Haemodynamics and Seizure Duration during Electroconvulsive Therapy

2002 ◽  
Vol 30 (6) ◽  
pp. 742-746 ◽  
Author(s):  
Z. Wajima ◽  
T. Yoshikawa ◽  
A. Ogura ◽  
T. Shiga ◽  
T. Inoue ◽  
...  
Keyword(s):  
Heart Rate ◽  
Electroconvulsive Therapy ◽  
Cardiovascular Responses ◽  
Injection Pain ◽  
Control Group ◽  
Seizure Duration ◽  
Double Blind ◽  
Routine Administration ◽  
Intravenous Saline ◽  
Risk Patients

Electroconvulsive therapy (ECT) is commonly associated with acute hyperdynamic cardiovascular responses, and we hypothesize that intravenous lignocaine can blunt this response. We have measured the effect of lignocaine 1.5 mg/kg IV on heart rate and mean arterial pressure during electroconvulsive therapy. Furthermore, we also assessed seizure duration using both the cuff method and two-lead electroencephalography. We studied 25 patients using a randomized, double-blind, placebo-controlled crossover study design. Patients in the control group were given intravenous saline 0.075 ml/kg, and those in the lignocaine group were given intravenous lignocaine 2% 1.5 mg/kg, and this treatment was conducted one minute before intravenous propofol 1.5 mg/kg to induce unconsciousness. Succinylcholine 1.5 mg/kg was then administered intravenously and electrical stimulation was administered after fasciculation. Measurements were taken at the baseline, prior to succinycholine, prior to electroconvulsive therapy and at the peak response after electroconvulsive therapy. Intravenous lignocaine significantly reduced the increases in heart rate after electroconvulsive therapy, as compared with the placebo. The use of intravenous lignocaine was, however, associated with a remarkably shortened seizure duration. Due to the reduction in seizure duration, routine administration of intravenous lignocaine may not be advisable since it may interfere with the psychotherapeutic efficacy of electroconvulsive therapy. However, intravenous lignocaine medication for electroconvulsive therapy is potentially useful for reducing tachycardia in high-risk patients and reducing the severity of propofol injection pain in comparison with a placebo.

scholarly journals Premedication with dexmedetomidine for prevention of hyperdynamic response after electroconvulsive therapy: a cross-over, randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pattika Subsoontorn ◽  
Varinee Lekprasert ◽  
Punjaporn Waleeprakhon ◽  
Pichai Ittasakul ◽  
Atchaporn Laopuangsak ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Electroconvulsive Therapy ◽  
Recovery Time ◽  
Controlled Trial ◽  
Saline Control ◽  
Control Group ◽  
Drug Infusion ◽  
Seizure Duration ◽  
Recovery Times

Abstract Background Electroconvulsive therapy (ECT) is an effective therapy for psychiatric disorders, but is associated with acute hyperdynamic responses including transient hypertension and tachycardia. This study aimed to assess the effectiveness of premedication with dexmedetomidine for hemodynamic attenuation after ECT and to evaluate its effects on seizure duration, postictal asystole duration, post ECT agitation and recovery time. Methods Twenty-four psychiatric patients who underwent a total of 72 ECT sessions (three sessions per patient) were randomly allocated to receive either dexmedetomidine 0.5 mcg/kg intravenous, dexmedetomidine 1 mcg/kg intravenous, or saline (control group) 15 min before the first ECT session. The patients subsequently received the other two premedication options for their next two ECT sessions. Blood pressure and heart rate were recorded at 5, 10, and 15 min after drug infusion and at 2.5, 5, 7.5, 10, 15, 20, 25, and 30 min after ECT. Asystole duration, seizure duration, post ECT agitation and recovery times were also recorded. Results The baseline characteristics were similar between the groups. Systolic blood pressure in both dexmedetomidine groups was significantly lower than that in the control group after ECT (p = 0.002). Diastolic blood pressure and heart rate were significantly lower in the dexmedetomidine 1 mcg/kg group (p = 0.002 and p = 0.013, respectively) compared with the control group. Asystole duration, seizure durations, post ECT agitation and recovery times were similar between the groups. Conclusions Dexmedetomidine 1 mcg/kg administered 15 min before ECT attenuated the hemodynamic response, including suppressing the systolic, diastolic and heart rate increases, during ECT without affecting recovery time. It also did not prolong the post-stimulus asystole duration. Trial registration TCTR20170715003, registered at Thai Clinical Trials Registry (TCTR), principal investigator: Pattika Subsoontorn, date of registration: 15/07/2017.

The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Task ◽  
Well Being ◽  
Control Group ◽  
Double Blind ◽  
Main Effect ◽  
The Difference ◽  
Being There ◽  
To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

Propofol Anaesthesia in Electroconvulsive Therapy

1994 ◽  
Vol 165 (4) ◽  
pp. 506-509 ◽  
Author(s):  
Christopher F. Fear ◽  
Carl S. Littlejohns ◽  
Eryl Rouse ◽  
Paul McQuail
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Induction Agent ◽  
Double Blind Study ◽  
Major Depressive ◽  
Seizure Duration ◽  
Double Blind ◽  
Induction Agents

BackgroundThe induction agent propofol is known to reduce electroconvulsive therapy (ECT) seizure duration. It is assumed that outcome from depression is adversely affected by this agent. This study compares propofol and methohexitone as induction agents for ECT.MethodIn a prospective, randomised, double-blind study 20 subjects with major depressive disorder (DSM-III-R criteria) received propofol or methohexitone anaesthesia. The Hamilton Depression Rating Scale and Beck Depression Inventory were used to assess depression before therapy, at every third treatment, and at the end of therapy. Seizure duration was measured using the cuff technique.ResultsMean seizure durations (P < 0.01) and mean total seizure duration (P < 0.01) were shorter in the propofol group. There was no difference in outcome.ConclusionsUse of propofol may not adversely affect outcome from depression and it is not necessarily contraindicated as an induction agent for ECT. Our results should be interpreted cautiously, and larger studies are needed.

scholarly journals Preventive Effect of Liothyronine on Electroconvulsive Therapy-Induced Memory Deficit in Patients with Major Depressive Disorder: A Double-Blind Controlled Clinical Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Arash Mohagheghi ◽  
Asghar Arfaie ◽  
Shahrokh Amiri ◽  
Masoud Nouri ◽  
Salman Abdi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Visual Memory ◽  
Memory Deficit ◽  
Control Group ◽  
Major Depressive ◽  
Double Blind ◽  
The Impact

Introduction and Objective. Despite the effectiveness of electroconvulsive therapy (ECT) in treating major depressive disorder (MDD), its cognitive side effects make it less popular. This study investigated the impact of liothyronine on ECT-induced memory deficit in patients with MDD.Methodology. This is a double-blind clinical trial, in which 60 patients with MDD who were referred for ECT were selected. The diagnosis was based on the criteria of DSM-IV-TR. Patients were divided randomly into two groups to receive either liothyronine (50 mcg every morning) or placebo. After the assessment with Wechsler Memory Scale-Revised (WMS-R) before first session of ECT, posttests were repeated again, two months after the completion of ECT.Findings. By controlling the pretest scores, the mean scores of the experimental group were higher than the control group in delayed recall, verbal memory, visual memory, general memory, and attention/concentration scales (P<0.05).Conclusion. Liothyronine may prevent ECT-induced memory impairment in patients with MDD. This study has been registered in IRCT underIRCT201401122660N2.

scholarly journals Music for pain in healthy neonates

2021 ◽  
Vol 61 (2) ◽  
pp. 69-73
Author(s):  
Nessie Amelia Ramli ◽  
Afifa Ramadanti ◽  
Indrayady Indrayady ◽  
Yuli Doris Memy
Keyword(s):  
Heart Rate ◽  
Pain Perception ◽  
Periventricular Leukomalacia ◽  
Pain Scale ◽  
Injection Pain ◽  
Medical Procedure ◽  
Music Intervention ◽  
Older Children ◽  
Double Blind ◽  
Infant Pain

Background The neonatal pain threshold is 30-50% lower than in adults and older children because of immature pain inhibition function in nervous centers. Acute pain in neonates results in behavioral, physiological, and cerebral blood flow changes that may lead to intraventricular bleeding and periventricular leukomalacia. Music is believed to reduce pain perception as it distracts, influencing the parasympathetic and sympathetic nervous system by decreasing pulse rate, blood pressure, and breathing, hence, promoting a relaxed state. Objective To evaluate effects of music intervention on physiological parameters and pain perception in healthy newborns undergoing a painful medical procedure (immunization injection). Methods This was a double-blind, randomized control trial study. A recorded instrumental lullaby “Nina Bobo” was given for 5 minutes to the music group and no music for control, prior injection of Hepatitis B 0. The evaluation of heart rate and SpO2 were performed at baseline, 30 seconds, and 5 minutes after injection. Pain perception were measured by Neonatal Infant Pain Scale (NIPS) at 30 seconds and 5 minutes after injection. Results Total of 51 subjects were enrolled. There were no difference of SpO2 and NIPS between both music and control groups. Music improved heart rate after 30 seconds and 5 minutes after injection,  median 126 (range 55-149) bpm from median 136 (range 78-154) bpm, and even lower than baseline [mean 128.9 (SD 12.5) bpm; P=0.019]. The control showed no improvement of heart rate mean 124,34 (SD 18,45) from 124,73 (SD 18,39); P=0.875There were no significant differences between the 2 groups. Conclusion Music is not effective in improving oxygen saturation, heart rate, and is not effective in reducing the degree of pain.

scholarly journals Is Local Anesthetic Infiltration Prior to Intravenous Cannulation Beneficial to Patients?

2013 ◽  
Vol 8 (1) ◽  
pp. 10-13
Author(s):  
Babu Raja Shrestha ◽  
U Shrestha ◽  
A Shrestha ◽  
A Rana
Keyword(s):  
Heart Rate ◽  
Local Anesthetic ◽  
Randomized Study ◽  
Cardiovascular Responses ◽  
Control Group ◽  
Venous Cannulation ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
Local Anesthetic Infiltration

Aims: Intravenous cannulation causes pain, anxiety and frustration in patients along with changes in hemodynamic parameters. Infiltration of local anesthetic lessens the pain of intravenous cannulation. This study was performed to compare cardiovascular responses and verbal rating pain scores in two groups with and without local anesthetic infiltration prior to venous cannulation. Methods: This was a randomized study conducted in 100 elective surgical patients, divided into two study groups with 50 patients in each: group A (Control) and group B (local anesthetic infiltration). Prior to venous cannulation in group B, 0.5 ml of 1% lidocaine was infiltrated at the procedure site at dorsum of the wrist. Patients in group A were cannulated directly without local anesthetic infiltration. The hemodynamic changes pre and post cannulation and verbal pain rating scores were recorded by blind observers in all patients. Results: Demographic values in two groups were similar. Increase in heart rate from baseline value was significant in control group (p < 0.05). Post cannulation heart rate, systolic and diastolic blood pressure were significantly higher in group A compared to group B for the first three minutes (p < 0.05). Amongst higher number of patients in group A, verbal rating pain score was significantly higher. Ninety-four percent of the patients in group B were pain free, comfortable and satisfied with the procedure. Conclusions: Intravenous cannulation can be made pain free with patient satisfaction and hemodynamic stability if carried out with prior local anesthetic infiltration. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 10-13 DOI: http://dx.doi.org/10.3126/njog.v8i1.8853

scholarly journals Comparative Study of the Effect of Midazolam Administration Before and after Seizures on the Prevention of Complications in Children Undergoing Electroconvulsive Therapy Compared with a Control Group

2022 ◽  
Author(s):  
Mehrdad Masoudifar ◽  
Behzad Nazemroaya ◽  
Maryam Raisi
Keyword(s):  
Muscle Pain ◽  
Anterograde Amnesia ◽  
Control Group ◽  
Seizure Duration ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
Before And After ◽  
Group A ◽  
Effective Role ◽  
Group B

Background: One of the complications of ECT treatment is headache. There is a need to use sedation during ECT. As a result, midazolam has been used to address a safe and effective strategy in this regard. Methods: This study is a double-blind clinical trial that has been performed in three groups: group A, which receives midazolam based on the usual regimen, group B, which receives midazolam after shock, and group C, which is the control group. Patients were asked about headache, nausea, and muscle aches during the recovery time, seizure duration and after becoming fully conscious. Data were analyzed in the PASW version18 software using analysis of variance and repeated measurement tests, ANOVA, independed t and χ2 tests. Results: Analysis showed that the frequency of muscle pain after full consciousness in group C was significantly higher than group B, with group B being higher than group A. χ2 test showed that the frequency of headache, cough and nausea in group C was significantly higher than the two groups A and B. Conclusion: The result of this research showed that midazolam prodrug plays an effective role in preventing post-ECT complications in children. The effect of midazolam before and after ECT on headache, muscle pain and nausea was investigated and compared with the control group. Also, due to its anterograde amnesia, midazolam can reduce the patient's stress in the next visits, and this issue is even more important when the patient is a child.

scholarly journals T197. TREATMENT STRATEGIES FOR ULTRA-RESISTANT SCHIZOPHRENIAS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S306-S307
Author(s):  
Octavian Vasiliu
Keyword(s):  
Electroconvulsive Therapy ◽  
Large Scale ◽  
Pragmatic Trial ◽  
Mood Stabilizers ◽  
Control Group ◽  
Double Blind ◽  
Meaningful Improvement ◽  
Treatment As Usual ◽  
Positive Effects ◽  
Number Of Patients

Abstract Background Treatment-resistant schizophrenias include a heterogeneous group of patients with significant individual and societal consequences, and a high number of these patients fail to respond to clozapine (almost 50%). Patients who did not respond to the second line antipsychotics are a challenge for their treating physicians and although many augmentation strategies have been tried, including other agents with antipsychotic properties, mood-stabilizers, antidepressants, glutamatergic agents and neuromodulation techniques. Methods A literature review was conducted in the main electronic databases (PubMed, Cochrane, EMBASE, CINAHL), and papers published between January 2000 and August 2019 were included. The search paradigm was “ultra-resistant schizophrenia” or “clozapine-resistant schizophrenia” or “add-on to schizophrenia” and non-proprietary names of currently marketed antipsychotics, mood stabilizers, antipsychotics, nootropics, “neuromodulation techniques” and “psychotherapy”. Results A number of 197 papers resulted from the primary search, and 45 papers remained after de-duplication and application of inclusion and exclusion criteria. Electroconvulsive therapy seems to be efficient and the response rate ranges from 37.5 to 100% in cases of ultra-resistant schizophrenia [1]. Transcranial direct-current stimulation (tDCS) lead to meaningful improvement in positive symptoms and overall symptomatology when compared to no standard treatment of the control group, in a 4 weeks trial [2]. A 21-week pragmatic trial did not find any significant lasting effect of the cognitive-behavioral therapy (CBT) on total symptoms of schizophrenia compared to treatment as usual, although improvements were detected [3]. Pharmacological augmentation of clozapine included amisulpride (results were not significant), memantine (positive effects, but the trial included a small number of patients), reboxetine (uncertain efficacy), ziprasidone (possible effective on negative and cognitive symptoms), aripiprazole (uncertain effect based on multiple trials), lamotrigine (not efficient), pimozide (not efficient), sertindole (no benefits detected, possible worsen psychosis in several cases), tetrabenazine (not effective), duloxetine (possible efficacy on negative and general psychopathology, but not on the executive cognitive functions), topiramate (no efficacy), valproic acid (possible efficacy, larger trials needed), risperidone (not efficient), donepezil (not efficient), mirtazapine (possible efficacy), sulpiride (possible efficacy in a subgroup of schizophrenia patients). Discussion Until now no single pharmacological augmentation strategy to clozapine has been proven superior to other in double-blind randomized, large-scale placebo-controlled data. Electroconvulsive therapy seems to be the only non-pharmacological technique with enough data to support its efficacy in ultra-resistant cases of schizophrenia. Other neuromodulatory techniques, like tDCS, are still in early phase of investigation, and psychotherapy does not have enough evidence to support its efficacy. References

scholarly journals The Role of Perceived Control in the Psychophysiological Responses to Disgust of Subclinical OCD Women

Sensors ◽  
2019 ◽  
Vol 19 (19) ◽  
pp. 4180 ◽  
Author(s):  
Serrano ◽  
Rosell-Clari ◽  
García-Soriano
Keyword(s):  
Heart Rate ◽  
Perceived Control ◽  
Subjective Experience ◽  
Cardiovascular Responses ◽  
Emotional Valence ◽  
Control Group ◽  
Avoidance Task ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Subclinical Ocd

Obsessive‒compulsive disorder (OCD), and especially contamination obsessions and washing compulsions, has been related to disgust. However, when its cardiovascular correlates have been studied, contradictory results have been found, including heart rate accelerations and decelerations. The aim of this study is to analyze emotional, cognitive, and cardiovascular responses in nonclinical (control) and subclinical participants with obsessive‒compulsive contamination/washing symptoms when confronted with a disgusting stimulus. Twenty-seven participants (14 subclinical OCD) completed a behavioral avoidance task with a contamination-based stimulus while their heart rate and subjective variables were measured. Results showed heart rate reductions in both samples, whereas subjective measures reflected higher disgust, anxiety, dirtiness, and emotional valence in the subclinical sample. However, at the same time, the sense of dominance was lower in the control group. In conclusion, our results support a heart rate deceleration during exposure to a disgusting stimulus dissociated from the subjective experience.

scholarly journals Effect of probiotic supplement (kidilact) on prevention of acute diarrhea in children: a double-blind randomized clinical trial

2017 ◽  
Vol 5 (7) ◽  
pp. 2861
Author(s):  
Mehran Hesaraki
Keyword(s):  
Clinical Trial ◽  
Heart Rate ◽  
Body Temperature ◽  
Randomized Clinical Trial ◽  
Intervention Group ◽  
Vital Signs ◽  
Control Group ◽  
Early Recovery ◽  
Double Blind ◽  
Viral Diarrhea

Background: Acute viral diarrhea is one of the most common diseases in children, which is associated with high risk of mortality. The present study aimed to determine the effect of Kidilact on the treatment of children with acute diarrhea.Methods: This double-blind randomized clinical trial was conducted on 84 children aged 6-60 months with diarrhea, hospitalized in pediatric ward of Amir al-Mu'minin hospital of Zabol, Iran. The patients who met the inclusion criteria were included and assigned to the control and treatment groups (42 patients in each group). Data collection instruments included clinical examination of participants in terms of gender, medication, diet, stool test, weight, average heart rate, average respiratory rate, average body temperature, and average frequency of defecation Data was analyzed with descriptive and analytical tests (chi-square, Fisher's exact test, t-test, etc.) in SPSS-21.Results: Body temperature, heart rate, and frequency of defecation significantly reduced in the intervention group after three days (p<0.05). In addition, weight gain presented an improving trend in the intervention group, but not significantly different from the control group (p<0.05).Conclusions: Findings indicated that the use of Kidilact may be helpful in the treatment of acute viral diarrhea in children and play a key role in early recovery, reduction of disease severity, and improvement of vital signs in these patients.

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