| Title |
Dexmedetomidine for the management of postictal agitation after electroconvulsive therapy with S-ketamine anesthesia
|
|---|---|
| Published in |
Neuropsychiatric Disease and Treatment, May 2017
|
| DOI | 10.2147/ndt.s134751 |
| Pubmed ID | |
| Authors |
Suna Su Aksay, Jan Malte Bumb, Dmitry Remennik, Manfred Thiel, Laura Kranaster, Alexander Sartorius, Christoph Janke |
| Abstract |
Postictal agitation (PIA) represents one of the most common complications during a modified electroconvulsive therapy (ECT) course. Its clinical management can be challenging especially in cases with poor response to benzodiazepines. Dexmedetomidine, a highly selective alpha-2 adrenoceptor agonist acting predominantly in the locus coeruleus, exerts sedative effects without causing relevant respiratory depression. To the best of our knowledge, this is the first study that aimed to assess the impact of dexmedetomidine use with S-ketamine anesthesia on PIA reduction in ECT. We retrospectively analyzed 7 patients who underwent 178 ECT sessions with S-ketamine anesthesia between June 2011 and July 2015 at the Central Institute of Mental Health Mannheim. In 101 sessions, the patients received dexmedetomidine in combination with S-ketamine anesthesia. The decision for dexmedetomidine use was based on individual clinical presentation (patients with positive PIA history). A multivariate repeated measurement logistic regression analysis was conducted to investigate the effect of dexmedetomidine use on the occurrence of PIA. We hypothesized that the use of dexmedetomidine reduced the incidence of PIA also in combination with S-ketamine anesthesia. The prevalence of PIA in ECT sessions with dexmedetomidine administration was lower (mean per patient, 34% vs 62%). In the multivariate logistic regression analysis, the use of dexmedetomidine predicted the non-occurrence of PIA in a highly significant manner (P=0.001, z=-3.83, odds ratio =0.011-0.303). Adjunctive use of dexmedetomidine to S-ketamine anesthesia in ECT seems to be a promising tool for the management of intractable PIA syndrome. |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 47 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 15% |
| Student > Bachelor | 5 | 11% |
| Other | 4 | 9% |
| Student > Master | 3 | 6% |
| Student > Doctoral Student | 2 | 4% |
| Other | 4 | 9% |
| Unknown | 22 | 47% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 17% |
| Nursing and Health Professions | 4 | 9% |
| Psychology | 4 | 9% |
| Agricultural and Biological Sciences | 3 | 6% |
| Neuroscience | 3 | 6% |
| Other | 4 | 9% |
| Unknown | 21 | 45% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 May 2017.
All research outputs
#22,764,772
of 25,382,440 outputs
Outputs from Neuropsychiatric Disease and Treatment
#2,583
of 3,131 outputs
Outputs of similar age
#284,174
of 324,557 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#59
of 78 outputs
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