ERSİN KÖKSAL, Yasemin Burcu ÜSTÜN, CENGİZ KAYA, AHMET RİFAT ŞAHİN, Ali Haydar ŞAHİNOĞLU

Elektrokonvülzif tedavide rokuronyum-sugammadeks ve süksinilkolinin derlenme üzerine etkilerinin karşılaştırılması

Amaç: Elektrokonvülzif tedavide (EKT) rokuronyum-sugammadeks ve süksinilkolinin derlenme ve yan etkiler açısından karşılaştırılması amaçlandı. Yöntem: En az altı seans EKT uygulanacak hastalar çalışmaya alındı. Genel anestezide 1 mg/kg propofol sonrası rokuronyum veya süksinilkolin uygulandı. EKT işlemi sonrası süksinilkolin grubu kendiliğinden derlenmeye bırakıldı, rokuronyum grubuna ise 4 mg/kg sugammadeks uygulandı. Kalp hızı, ortalama arter basıncı, oksijen saturasyonu, spontan solunum süresi, göz açma süresi, emirlere uyum süresi, motor nöbet süresi, yan etkiler, T1 %0 ve %90 olma süreleri değerleri, Modifiye Aldrete Skorları (MAS) ve MAS 9 olma süreleri kaydedildi. Bulgular: Gruplar arası karşılaştırmada T1 %0 olma süresi süksinilkolin grubunda anlamlı olarak daha kısa saptandı. T1 %90 olma süresi ise rokuronyum-sugammadeks grubunda daha kısa bulundu. Motor nöbet süreleri rokuronyum-sugammadeks grubunda daha uzundu. İşlem sonu MAS rokuronyum-sugammadeks grubunda daha düşük bulundu, ancak MAS 9 olma zamanı rokuronyum-sugammadeks grubunda daha kısaydı. Göz açma, emirlere uyum ve spontan solunum süreleri rokuronyum-sugammadeks grubunda daha kısa bulundu. Tartışma: EKT uygulamalarında rokuronyum-sugammadeks kombinasyonu kullanım ı, yeterli kas gevşemesi ve erken derlenme sağlar. EKTde rokuronyum-sugammadeks süksinilkoline alternatif olarak kullanılabilir.

Comparing the effects of rocuronium-sugammadex and succinylcholine on recovery during electroconvulsive therapy

Objective: We aimed to compare the effects of rocuronium-sugammadex and succinylcholine on the recovery and side effects during the electro-convulsive therapy (ECT). Methods: Patients who received at least 6 sessions ECT are involved into this study. For general anesthesia, following 1 mg/kg propofol, rocuronium or succinylcholine were applied. After ECT process, succinylcholine group was left to recovery on its own, but rocuronium group was received 4 mg/kg sugammadeks. Heart rate, mean blood pressure, oxygen saturation, spontaneous breathing time, time of opening eyes, time of obeying the instructions, motor seizure duration, side effects, timing of T1 0% and 90%, Modified Aldrete Scores (MAS) and timing of MAS 9 were recorded. Results: When the groups were compared, time of T1 being 0% in succinylcholine group was meaningfully shorter. Time of T1 being 90% was shorter in rocuronium-sugammadex group. Motor seizure duration was longer in the rocuronium-sugammadex group. After ECT process MAS was found lower in the rocuronium-sugammadex group, timing of MAS 9 was shorter in rocuronium-sugammadex group. Opening eyes, obeying the instructions and spontenous breathing time were shorter in rocuronium-sugammadex group. Conclusion: Use of rocuronium-sugammadex combination provides sufficient muscle relaxation and early recovery during ECT. Rocuronium-sugammadex can be used as an alternative to succinylcholine in ECT.

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