Effect of Intravenous Alfentanil on Hemodynamic Changes in Anesthesia for Electroconvulsive Therapy

Background : Electroconvulsive therapy is one of the therapeutic ways to treat several severe and threatening psychiatric disorders that may cause hemodynamic complications. This study was conducted to examine the effects of intravenous alfentanil on heart rate, mean arterial pressure, seizure duration, respiratory arrest, and recovery after electroconvulsive therapy (ECT).
Materials and Methods : A total of 100 patients with psychiatric disorder were examined in a prospective randomized double-blind study. Alfentanil, thiopental, and succinylcholine were administered to 50 subjects, and the remaining subjects received normal saline, thiopental, and succinylcholine, in that neither the patient nor the injector was aware of alfentanil or normal saline in A and B coded syringes.
Results : Two groups were not significantly different by age and sex. Average values of mean arterial pressure changes, immediately after ETC, were 5.41±1.9 and 32.29±2.7 in alfentanil and placebo groups, respectively. Mean values of heart rate changes, immediately after ECT, were 10.78±0.8 and 22.6±1.2 in alfentanil and placebo groups, respectively. Alfentanil significantly reduced heart rate and mean arterial pressure, after electroconvulsive. Alfentanil had no significant effect on seizure duration, respiratory arrest, and recovery.
Conclusion : Alfentanil probably could be useful to reduce ECT-induced tachycardia and hypertension in high-risk patients without affecting seizure duration and treatment effects of ECT.