Objectives: Electroconvulsive therapy (ECT) is a safe and efficient treatment as a last line of intervention for psychiatric disorders. Usually respiratory problems are observed after ECT procedure. In present study, we investigated effects of atropine and aminophylline on respiratory problems that occur after ECT undergoing general anesthesia.
Methods: Present study is a randomized, double blind, crossover trial. Patients were entered study either non-premedicated as Control Group or premedicated with atropine as Atropine Group or premedicated with aminophylline as Aminophylline Group in different ECT sessions. The demographics, psychiatric diagnoses and hemodynamic data of the patients were recorded. The respiratory sounds were auscultated before and after the ECT. Findings were recorded as normal respiratory sounds, fine crackles, coarse crackles or wheezing. Patients whose SpO2 values were <90% were recorded separately. The period of time required for recovery of pathological respiratory sounds, seizure duration and anesthesia recovery time were recorded.
Results: The number of patients with low SpO2 values and abnormal respiratory auscultation signs were less and recovery period of patient’s were found shorter in Atropine Group. Depending on logistic regression analysis longer seizure duration was associated with increased incidence of respiratory problems (p<0.001, odd ratio=1.23, %95CI:1.147-1.319). The risky seizure duration cut-off values were found 33sec., 39.5sec. and 41.5sec. at control, Atropine and Aminophylline Group respectively.
Conclusions: We have observed that respiratory problems develop frequently after ECT and atropine or aminophylline administration decreases the incidence of respiratory problems. We have also found that longer duration of seizure was a risk factor for respiratory problems and atropine premedication extend risky seizure duration.