ATROPINE PREMEDICATION AND THE CARDIOVASCULAR RESPONSE FOLLOWING ELECTROCONVULSIVE THERAPY

Background: Electroconvulsive therapy (ECT) is a useful non-pharmacologic tool for treating major depression and other neurologic disorders. However, it may lead to bradycardia and consequently to tachycardia and hypertension. Atropine is considered as premedication of choice. We have studied the cardiovascular response following the ECT procedure. Materials and Methods: 80 patients had entered this double-blinded clinical trial. Patients were randomly assigned in either case or control. The case group was intravenously given 0.5mg atropine before the anesthesia induction, however, the control group received 1ml normal saline. Blood pressure and heart rate were monitored 1 minute after the induction and at minutes 1, 3 and 5 after ECT. Results: The case and control groups were composed of 31 males and 9 females. The mean age of case and control group was 35.3±7.8 and 33±7.6 years, respectively (NS). At minute 3, the mean blood pressure was higher in the case group (P=-0.43). At minutes 1 after induction and 5 after ETC the mean heart rate was faster in the case group (P Conclusion: Administration of atropine as a premedication agent may lead to transient hypertension, meanwhile those who haven’t received atropine (Control), had no bradycardia. We don’t suggest atropine as the routine premedication agent before ECT, especially in whom hypodynamic heart, usage of sympathetic inhibitor and previous history of bradycardia following the ECT procedure exist.