A comparison of the effects of succinylcholine and rocuronium on recovery time from anesthesia and vital signs in electroconvulsive therapy

Abstract

Aims: Electroconvulsive therapy (ECT) is based on stimulation of brain tissue with an electrical current and the induction of generalized convulsions. The aim of this study was to compare the use of rocuronium as a muscle relaxant and sugammadex as an antidote during ECT with succinylcholine in terms of its effect on adequate anesthesia, hemodynamics, and recovery. Methods: This study was planned as a single-center prospectively collected and retrospectively analyzed observational cohort study. Patients were divided into two groups as group S (succinylcholine) and group R+S (rocuronium and sugammadex). Patients were premedicated with 0.5 mg of atropine I.M. half an hour before the procedure. Propofol 1mg/kg was administered as an induction agent in both groups, succinylcholine 1mg/kg in Group S, and rocuronium 0.4mg/kg in Group R+S. Sugammadex 2mg/kg was administered as a rocuronium antidote. Vital signs were monitored throughout the procedure with ECG, spo2, and blood pressure monitoring. Results: There was a statistically significant difference between the two groups (Group S and Group R+S) in the time to return for spontaneous respiration (p=0.002). The mean SSS value was 111.78 seconds in Group S and 88.82 seconds in Group R+S. There was a statistically significant difference between the spontaneous eye-opening times between Group S and Group R+S. (p=0.017) The mean SGA value was 211.42 seconds in Group S and 173.12 seconds in Group R+S. There was a statistically significant difference between Group S and Group R+S in the duration of modified Aldrete score 9 (p=0.000<0.05). The mean duration of MAS 9 was 542.60 seconds in Group S and 410.54 seconds in Group R+S. Conclusion: In conclusion, although the high cost of rocuronium sugammadex limits its routine use in ECT anesthesia, it can be used as an ideal alternative agent in cases where succinylcholine is contraindicated or anticholinesterases are not suitable because it shortens the recovery time and the time to return of spontaneous respiration compared to succinylcholine.