TY - JOUR
T1 - Trimethaphan (arfonad) control of hypertension and tachycardia during electroconvulsive therapy
T2 - A double-blind study
AU - Petrides, Georgios
AU - Maneksha, Farrokh
AU - Zervas, Iannis
AU - Carasiti, Irene
AU - Francis, Andrew
PY - 1996/3
Y1 - 1996/3
N2 - Study Objective: To ascertain the optimal dose of trimethaphan camsylate administered by intravenous (IV) bolus injection for the control of hypertension and tachycardia during electroconvulsive therapy (ECT). Design: Prospective, double blind, within-subject study. Setting: Treating room of the psychiatric unit of the University Hospital at Stony Brook, NY. Subjects: Patients undergoing ECT for major psychiatric illnesses. Measurements and Main Results: Fifteen ASA status I or II patients received in a random sequence placebo, or 5, 10, or 15 mg boluses of trimethaphan during their second to fifth treatments. Blood pressure (BP) and heart rate (HR) were recorded every 30 seconds by automated oscillometric recorder. Recordings taken before administration, during seizure, 5, and 20 minutes after seizure were examined. All doses ameliorated BP (systolic, diastolic, and mean), HR, and rate pressure product (RPP) increases during the seizure, compared with placebo. The group that received 15 mg exhibited smaller increases in RPP, i.e., 67.7% increase compared with 155.4%, 110.9%, and 98.7% increases for the placebo, 5, and 10 mg, respectively. The 10 mg and 15 mg doses caused a faster return to baseline than did the 5 mg dose or placebo. No rebound hypertension, prolonged hypotension, arrhythmias, or other side effects were noted. Trimethaphan did not alter seizure duration. Conclusions. Trimethaphan is safe, practical, and effective in the management of the hyperdynamic response to ECT. An IV bolus injection of 15 mg is more effective than 10 mg or 5 mg.
AB - Study Objective: To ascertain the optimal dose of trimethaphan camsylate administered by intravenous (IV) bolus injection for the control of hypertension and tachycardia during electroconvulsive therapy (ECT). Design: Prospective, double blind, within-subject study. Setting: Treating room of the psychiatric unit of the University Hospital at Stony Brook, NY. Subjects: Patients undergoing ECT for major psychiatric illnesses. Measurements and Main Results: Fifteen ASA status I or II patients received in a random sequence placebo, or 5, 10, or 15 mg boluses of trimethaphan during their second to fifth treatments. Blood pressure (BP) and heart rate (HR) were recorded every 30 seconds by automated oscillometric recorder. Recordings taken before administration, during seizure, 5, and 20 minutes after seizure were examined. All doses ameliorated BP (systolic, diastolic, and mean), HR, and rate pressure product (RPP) increases during the seizure, compared with placebo. The group that received 15 mg exhibited smaller increases in RPP, i.e., 67.7% increase compared with 155.4%, 110.9%, and 98.7% increases for the placebo, 5, and 10 mg, respectively. The 10 mg and 15 mg doses caused a faster return to baseline than did the 5 mg dose or placebo. No rebound hypertension, prolonged hypotension, arrhythmias, or other side effects were noted. Trimethaphan did not alter seizure duration. Conclusions. Trimethaphan is safe, practical, and effective in the management of the hyperdynamic response to ECT. An IV bolus injection of 15 mg is more effective than 10 mg or 5 mg.
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U2 - 10.1016/0952-8180(95)00192-1
DO - 10.1016/0952-8180(95)00192-1
M3 - Article
C2 - 8695090
AN - SCOPUS:0029924139
SN - 0952-8180
VL - 8
SP - 104
EP - 109
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 2
ER -