Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
European Archives of Psychiatry and Clinical Neuroscience
Erschienen in: European Archives of Psychiatry and Clinical Neuroscience 8/2016

28.01.2016 | Original Paper

Remifentanil in electroconvulsive therapy: a systematic review and meta-analysis of randomized controlled trials

verfasst von: Yoshiteru Takekita, Taro Suwa, Naotaka Sunada, Hirotsugu Kawashima, Chiara Fabbri, Masaki Kato, Aran Tajika, Toshihiko Kinoshita, Toshi A. Furukawa, Alessandro Serretti

Erschienen in: European Archives of Psychiatry and Clinical Neuroscience | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Abstract

In electroconvulsive therapy (ECT), remifentanil is often used concurrently with anesthetics. The objective of this study was to provide an up-to-date and comprehensive review on how the addition of remifentanil to anesthetics affects seizure duration and circulatory dynamics in mECT. We performed a meta-analysis of RCTs that investigated seizure duration and circulatory dynamics in patients treated with ECT using anesthetics alone (non-remifentanil group) and with anesthetics plus remifentanil (remifentanil group). A total of 13 RCTs (380 patients and 1024 ECT sessions) were included. The remifentanil group showed a significantly prolonged seizure duration during ECT compared to the non-remifentanil group [motor: 9 studies, SMD = 1.25, 95 % CI (0.21, 2.29), p = 0.02; electroencephalogram: 8 studies, SMD = 0.98, 95 % CI (0.14, 1.82), p = 0.02]. The maximum systolic blood pressure (SBP) was significantly reduced in the remifentanil group compared to the non-remifentanil group [7 studies, SMD = −0.36, 95 % CI (−0.65, 0.07), p = 0.02]. Substantial heterogeneity was observed for meta-analyses for seizure durations, but a pre-planned subgroup analysis revealed that seizure duration was prolonged only when the use of the anesthetic dose was reduced in the remifentanil group. The results of our study suggest that addition of remifentanil to anesthesia in ECT may lead to prolonged seizure duration when it allows the use of reduced anesthetic doses. Further, the addition of remifentanil was associated with reduced maximum SBP.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Ahsan B, Vahedi MS, Shami S, Arasteh M (2008) Assessment of the effect of addition of propofol to remifentanil on seizure duration, homodynamic change and recovery from anesthesia. Sci J Kurd Univ Med Sci 13:Pe21–Pe27 (En23)
2.
Akcaboy ZN, Akcaboy EY, Yigitbasl B, Bayam G, Dikmen B, Gogus N, Dilbaz N (2005) Effects of remifentanil and alfentanil on seizure duration, stimulus amplitudes and recovery parameters during ect. Acta Anaesthesiol Scand 49:1068–1071CrossRefPubMed
3.
American Psychiatric Association (2001) The practice of electroconvulsive therapy; recommendations for treatment, training, and privileging (a task force report of the american psychiatric association), 2nd edn. American Psychiatric Publishing, Washington, DC
4.
Andersen FA, Arsland D, Holst-Larsen H (2001) Effects of combined methohexitone–remifentanil anaesthesia in electroconvulsive therapy. Acta Anaesthesiol Scand 45:830–833CrossRefPubMed
5.
Avramov MN, Husain MM, White PF (1995) The comparative effects of methohexital, propofol, and etomidate for electroconvulsive therapy. Anesth Analg 81:596–602PubMed
6.
Ayhan A, Hüseyin Ş, Alpay AM, Tamer Y, Onur D, Sezai Ö, Cengiz B, Başar SÜ, Servet E, Güner D, Mesut Ç (2009) Elektrokonvülzif tedavide propofol ile propofol remifentanil kombinasyonun nöbet süresi ve hemodinami üzerine etkisi. Klinik Psikofarmakoloji Bülteni 19:24–28
7.
Azuma H, Fujita A, Sato K, Arahata K, Otsuki K, Hori M, Mochida Y, Uchida M, Yamada T, Akechi T, Furukawa TA (2007) Postictal suppression correlates with therapeutic efficacy for depression in bilateral sine and pulse wave electroconvulsive therapy. Psychiatry Clin Neurosci 61:168–173CrossRefPubMed
8.
Bauer M, Pfennig A, Severus E, Whybrow PC, Angst J, Moller HJ, World Federation of Societies of Biological Psychiatry. Task Force on Unipolar Depressive D (2013) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry 14:334–385CrossRefPubMed
9.
Begec Z, Erdogan Kayhan G, Toprak HI, Sahin T, Konur H, Colak C, Durmus M, Ersoy MO (2013) Sevoflurane alone and propofol with or without remifentanil for electroconvulsive therapy—a randomised, crossover study. Anaesth Intensive Care 41:202–206PubMed
10.
Chen ST (2011) Remifentanil: a review of its use in electroconvulsive therapy. J ECT 27:323–327CrossRefPubMed
11.
Coghill DR, Seth S, Pedroso S, Usala T, Currie J, Gagliano A (2014) Effects of methylphenidate on cognitive functions in children and adolescents with attention-deficit/hyperactivity disorder: evidence from a systematic review and a meta-analysis. Biol Psychiatry 76:603–615CrossRefPubMed
12.
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed
13.
Ding Z, White PF (2002) Anesthesia for electroconvulsive therapy. Anesth Analg 94:1351–1364CrossRefPubMed
14.
Dinwiddie SH, Glick DB, Goldman MB (2012) The effect of propofol–remifentanil anesthesia on selected seizure quality indices in electroconvulsive therapy. Brain Stimul 5:402–407CrossRefPubMed
15.
Egan TD, Lemmens HJ, Fiset P, Hermann DJ, Muir KT, Stanski DR, Shafer SL (1993) The pharmacokinetics of the new short-acting opioid remifentanil (GI87084B) in healthy adult male volunteers. Anesthesiology 79:881–892CrossRefPubMed
16.
17.
Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A (2002) Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol 31:140–149CrossRefPubMed
18.
Elefteriades JA, Hatzaras I, Tranquilli MA, Elefteriades AJ, Stout R, Shaw RK, Silverman D, Barash P (2003) Weight lifting and rupture of silent aortic aneurysms. JAMA 290:2803CrossRefPubMed
19.
Geretsegger C, Nickel M, Judendorfer B, Rochowanski E, Novak E, Aichhorn W (2007) Propofol and methohexital as anesthetic agents for electroconvulsive therapy: a randomized, double-blind comparison of electroconvulsive therapy seizure quality, therapeutic efficacy, and cognitive performance. J ECT 23:239–243CrossRefPubMed
20.
Glass PS, Hardman D, Kamiyama Y, Quill TJ, Marton G, Donn KH, Grosse CM, Hermann D (1993) Preliminary pharmacokinetics and pharmacodynamics of an ultra-short-acting opioid: remifentanil (GI87084B). Anesth Analg 77:1031–1040CrossRefPubMed
21.
Group UER (2003) Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 361:799–808CrossRef
22.
Guan L, Guo XY, Li Q (2011) Effect of remifentanil or esmolol on stress response during electric shock therapy in psychiatric patients. Zhonghua Yi Xue Za Zhi 91:769–771PubMed
23.
Gurkan Y, Yildiz T, Tural U, Onder E, Solak M, Toker K (2004) Effects of remifentanil on thiopental dose, duration of convulsion and to hemodynamic response during electroconvulsive therapy. Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi 32:269–273
24.
Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods G, Cochrane Statistical Methods G, Cochrane Statistical Methods G (2011) The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928CrossRefPubMedPubMedCentral
25.
Higgins JP, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0. In: The Cochrane Collaboration
26.
27.
Hooten WM, Rasmussen KG Jr (2008) Effects of general anesthetic agents in adults receiving electroconvulsive therapy: a systematic review. J ECT 24:208–223CrossRefPubMed
28.
29.
Kadoi Y, Saito S (2015) Effects of adding remifentanil to propofol anesthesia on systemic hemodynamics, cardiac output, and middle cerebral artery flow velocity during electroconvulsive therapy: a pilot study. J ECT 31:98–100CrossRefPubMed
30.
Kapila A, Glass PS, Jacobs JR, Muir KT, Hermann DJ, Shiraishi M, Howell S, Smith RL (1995) Measured context-sensitive half-times of remifentanil and alfentanil. Anesthesiology 83:968–975CrossRefPubMed
31.
Kennedy SH, Milev R, Giacobbe P, Ramasubbu R, Lam RW, Parikh SV, Patten SB, Ravindran AV, Canadian Network for M, Anxiety T (2009) Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. IV. Neurostimulation therapies. J Affect Disord 117(Suppl 1):S44–S53CrossRefPubMed
32.
Krystal AD, Coffey CE, Weiner RD, Holsinger T (1998) Changes in seizure threshold over the course of electroconvulsive therapy affect therapeutic response and are detected by ictal EEG ratings. J Neuropsychiatry Clin Neurosci 10:178–186CrossRefPubMed
33.
Krystal AD, Weiner RD, Lindahl V, Massie R (2000) The development and retrospective testing of an electroencephalographic seizure quality-based stimulus dosing paradigm with ECT. J ECT 16:338–349CrossRefPubMed
34.
Lalla FR, Milroy T (1996) The current status of seizure duration in the practice of electroconvulsive therapy. Can J Psychiatry 41:299–304PubMed
35.
Les AS, Shadden SC, Figueroa CA, Park JM, Tedesco MM, Herfkens RJ, Dalman RL, Taylor CA (2010) Quantification of hemodynamics in abdominal aortic aneurysms during rest and exercise using magnetic resonance imaging and computational fluid dynamics. Ann Biomed Eng 38:1288–1313CrossRefPubMed
36.
Lihua P, Su M, Ke W, Ziemann-Gimmel P (2014) Different regimens of intravenous sedatives or hypnotics for electroconvulsive therapy (ECT) in adult patients with depression. Cochrane Database Syst Rev 4:CD009763
37.
Locala JA, Irefin SA, Malone D, Cywinski JB, Samuel SW, Naugle R (2005) The comparative hemodynamic effects of methohexital and remifentanil in electroconvulsive therapy. J ECT 21:12–15CrossRefPubMed
38.
Loo C, Katalinic N, Mitchell PB, Greenberg B (2011) Physical treatments for bipolar disorder: a review of electroconvulsive therapy, stereotactic surgery and other brain stimulation techniques. J Affect Disord 132:1–13CrossRefPubMed
39.
Loo C, Simpson B, MacPherson R (2010) Augmentation strategies in electroconvulsive therapy. J ECT 26:202–207CrossRefPubMed
40.
Martinez-Amoros E, Galvez Ortiz V, Porter Moli M, Llorens Capdevila M, Cerrillo Albaiges E, Garcia-Pares G, Cardoner Alvarez N, Urretavizcaya Sarachaga M (2014) Propofol and thiopental as anesthetic agents in electroconvulsive therapy: a retrospective study in major depression. Rev Psiquiatr Salud Ment 7:42–47CrossRefPubMed
41.
Matute E, Alsina E, Roses R, Blanc G, Perez-Hernandez C, Gilsanz F (2002) An inhalation bolus of sevoflurane versus an intravenous bolus of remifentanil for controlling hemodynamic responses to surgical stress during major surgery: a prospective randomized trial. Anesth Analg 94:1217–1222 (table of contents) CrossRefPubMed
42.
Mayur P (2006) Ictal electroencephalographic characteristics during electroconvulsive therapy: a review of determination and clinical relevance. J ECT 22:213–217CrossRefPubMed
43.
McKeage K, Perry CM (2003) Propofol: a review of its use in intensive care sedation of adults. CNS Drugs 17:235–272CrossRefPubMed
44.
Miura K, Nakagawa H, Ohashi Y, Harada A, Taguri M, Kushiro T, Takahashi A, Nishinaga M, Soejima H, Ueshima H, Japan Arteriosclerosis Longitudinal Study G (2009) Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies. Circulation 119:1892–1898CrossRefPubMed
45.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535CrossRefPubMedPubMedCentral
46.
Nasseri K, Arasteh MT, Maroufi A, Shami S (2009) Effects of remifentanil on convulsion duration and hemodynamic responses during electroconvulsive therapy: a double-blind, randomized clinical trial. J ECT 25:170–173CrossRefPubMed
47.
Nishikawa K, Higuchi M, Kawagishi T, Shimodate Y, Yamakage M (2011) Effect of divided supplementation of remifentanil on seizure duration and hemodynamic responses during electroconvulsive therapy under propofol anesthesia. J Anesth 25:29–33CrossRefPubMed
48.
Noseir RK, Ficke DJ, Kundu A, Arain SR, Ebert TJ (2003) Sympathetic and vascular consequences from remifentanil in humans. Anesth Analg 96:1645–1650 (table of contents) CrossRefPubMed
49.
Perera TD, Luber B, Nobler MS, Prudic J, Anderson C, Sackeim HA (2004) Seizure expression during electroconvulsive therapy: relationships with clinical outcome and cognitive side effects. Neuropsychopharmacology 29:813–825CrossRefPubMed
50.
51.
Porter R, Booth D, Gray H, Frampton C (2008) Effects of the addition of remifentanil to propofol anesthesia on seizure length and postictal suppression index in electroconvulsive therapy. J ECT 24:203–207CrossRefPubMed
52.
Rasmussen K (2002) The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging (second edition). J ECT 18:58–59CrossRefPubMed
53.
Recart A, Rawal S, White PF, Byerly S, Thornton L (2003) The effect of remifentanil on seizure duration and acute hemodynamic responses to electroconvulsive therapy. Anesth Analg 96:1047–1050 (table of contents) CrossRefPubMed
54.
Rezaei F, Nasseri K, Esfandiari GR, Sadeghi SM, Fathie M, Gharibi F (2012) Remifentanil added to propofol for induction of anesthesia can reduce reorientation time after electroconvulsive therapy in patients with severe mania. J ECT 28:124–127CrossRefPubMed
55.
Roberts I, Sydenham E (2012) Barbiturates for acute traumatic brain injury. Cochrane Database Syst Rev 12:CD000033PubMed
56.
Sackeim HA, Devanand DP, Prudic J (1991) Stimulus intensity, seizure threshold, and seizure duration: impact on the efficacy and safety of electroconvulsive therapy. Psychiatr Clin N Am 14:803–843
57.
Sedighinejad A, Nabi BN, Haghighi M, Farzam A, Sayyah Z, Kabiri M, Soleimani R, Alavi CE (2015) Electroconvulsive therapy-related cognitive impairment and choice of anesthesia: the tipping point. J ECT 31:101–104CrossRefPubMed
58.
Smith DL, Angst MS, Brock-Utne JG, DeBattista C (2003) Seizure duration with remifentanil/methohexital vs. methohexital alone in middle-aged patients undergoing electroconvulsive therapy. Acta Anaesthesiol Scand 47:1064–1066CrossRefPubMed
59.
Takeshima N, Sozu T, Tajika A, Ogawa Y, Hayasaka Y, Furukawa TA (2014) Which is more generalizable, powerful and interpretable in meta-analyses, mean difference or standardized mean difference? BMC Med Res Methodol 14:30CrossRefPubMedPubMedCentral
60.
Taylor D, Paton C, Kapur S (2011) The Maudsley prescribing guidelines in psychiatry, 11th edn. Wiley-Blackwell, London
61.
62.
63.
Thompson JW, Weiner RD, Myers CP (1994) Use of ECT in the United States in 1975, 1980, and 1986. Am J Psychiatry 151:1657–1661CrossRefPubMed
64.
Ulusoy H, Cekic B, Besir A, Geze S, Hocaoglu C, Akdogan A (2014) Sevoflurane/remifentanil versus propofol/remifentanil for electroconvulsive therapy: comparison of seizure duration and haemodynamic responses. J Int Med Res 42:111–119CrossRefPubMed
65.
van Zijl DH, Gordon PC, James MF (2005) The comparative effects of remifentanil or magnesium sulfate versus placebo on attenuating the hemodynamic responses after electroconvulsive therapy. Anesth Analg 101:1651–1655CrossRefPubMed
66.
Villalonga A, Bernardo M, Gomar C, Fita G, Escobar R, Pacheco M (1993) Cardiovascular response and anesthetic recovery in electroconvulsive therapy with propofol or thiopental. Convuls Ther 9:108–111PubMed
67.
Vishne T, Aronov S, Amiaz R, Etchin A, Grunhaus L (2005) Remifentanil supplementation of propofol during electroconvulsive therapy: effect on seizure duration and cardiovascular stability. J ECT 21:235–238CrossRefPubMed
68.
Wagner KJ, Mollenberg O, Rentrop M, Werner C, Kochs EF (2005) Guide to anaesthetic selection for electroconvulsive therapy. CNS Drugs 19:745–758CrossRefPubMed
69.
Wells DG, Davies GG (1987) Hemodynamic changes associated with electroconvulsive therapy. Anesth Analg 66:1193–1195CrossRefPubMed
70.
Westmoreland CL, Hoke JF, Sebel PS, Hug CC Jr, Muir KT (1993) Pharmacokinetics of remifentanil (GI87084B) and its major metabolite (GI90291) in patients undergoing elective inpatient surgery. Anesthesiology 79:893–903CrossRefPubMed
Metadaten
Titel
Remifentanil in electroconvulsive therapy: a systematic review and meta-analysis of randomized controlled trials
verfasst von
Yoshiteru Takekita
Taro Suwa
Naotaka Sunada
Hirotsugu Kawashima
Chiara Fabbri
Masaki Kato
Aran Tajika
Toshihiko Kinoshita
Toshi A. Furukawa
Alessandro Serretti
Publikationsdatum
28.01.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Psychiatry and Clinical Neuroscience / Ausgabe 8/2016
Print ISSN: 0940-1334
Elektronische ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-016-0670-0

Weitere Artikel der Ausgabe 8/2016

European Archives of Psychiatry and Clinical Neuroscience 8/2016 Zur Ausgabe

Original Paper

EEG marker of inhibitory brain activity correlates with resting-state cerebral blood flow in the reward system in major depression

Original Paper

Two-week neurasthenic major depression

Original Paper

Elevated midline-parietal gamma band noise power in schizophrenia but not in bipolar patients

Short Communication

Exploring possible association between DβH genotype (C1021T), early onset of conduct disorder and psychopathic traits in juvenile delinquents

Original Paper

Does remifentanil improve ECT seizure quality?

Invited Review

tDCS for the treatment of depression: a comprehensive review

Neu im Fachgebiet Psychiatrie

18.04.2024 | Arterielle Hypertonie | Nachrichten

Antihypertensiva schützen auch alte Menschen noch vor Demenz

17.04.2024 | Delir nicht substanzbedingt | Nachrichten

Delir kann Demenz begünstigen

16.04.2024 | Störungen der Geschlechtsidentität | Nachrichten

Zunahme von Geschlechtsinkongruenz und -dysphorie registriert

12.04.2024 | Vitiligo | Nachrichten

Vitiligo: Prävalenz steigt und viele Erkrankte werden spät behandelt
weitere anzeigen

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen