Acute hemodynamic responses to electroconvulsive therapy are not related to the duration of seizure activity.

STUDY OBJECTIVE

To test the hypothesis that the magnitude of the acute hemodynamic response to electroconvulsive therapy (ECT) is related to the duration of the seizure activity in patients receiving different dosages of intravenous (i.v.) lidocaine.

DESIGN

Randomized, double-blind, placebo-controlled, cross-over study.

SETTING

University-affiliated hospital.

PATIENTS

21 ASA physical status I, II, and III patients undergoing four consecutive maintenance ECT treatments for chronic depression.

INTERVENTIONS

Patients received lidocaine 50 mg, 100 mg, 200 mg i.v., or saline prior to induction of anesthesia via a standardized anesthetic technique.

MEASUREMENTS AND MAIN RESULTS

Noninvasive blood pressure (BP) and heart rate (HR), as well as the duration of motor and electroencephalographic (EEG) seizure, were measured. The duration of motor and EEG seizures (means +/- SD) were 37 +/- 13 sec and 64 +/- 21 sec, 25 +/- 11 sec and 52 +/- 43 sec, 17 +/- 12 sec and 32 +/- 17 sec, 1 +/- 3 sec and 18 +/- 10 sec in the saline, lidocaine 50 mg, 100 mg, 200 mg groups, respectively. Although the duration of seizure activity was decreased in a dose-related fashion after lidocaine pretreatment, the peak increases in BP and HR were similar in the lidocaine and saline treatment groups.

CONCLUSIONS

Despite producing dose-related decreases in the duration of both motor and EEG seizure activity, lidocaine failed to attenuate the acute hemodynamic response to ECT. Thus, the acute hemodynamic response to ECT is not related to the duration of seizure activity.