Hemodynamic Status in Electroconvulsive Therapy Patients

Background Electroconvulsive therapy (ECT) is a safe and practical treatment method for patients with severe, refractory, or emergency psychiatric disorders. However, ECT is often associated with hemodynamic fluctuations. Objective This study aims to investigate the patterns of hemodynamic changes in patients undergoing ECT. Methods This longitudinal study was conducted in Shafa Hospital, a referral and academic center in Rasht City, Iran, in 2020. The hemodynamic parameters, including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded before the induction of anesthesia (T0), 1 min after the induction of anesthesia (T1), 1 min after the seizure (T2), and 15 min after the wakefulness (T3). The trend of changes of these parameters was compared in the above-mentioned time intervals. Results The data from 126 patients were analyzed. Most of the cases were diagnosed with a psychotic disorder of schizophrenia (59.5%) and a minority had major depression (14.3%). Meanwhile, 15.9% of the patients suffered from comorbidities. In terms of SBP, DBP, and MAP, the trend of changes was significant (P=0.0001) at four measurement point times, but this was not true for HR (P=0.74). However, all changes in the hemodynamic parameters were kept in the normal range. Conclusion Our study showed that despite the fluctuations in the hemodynamic parameters during ECT, patient management was acceptable as a result of the teamwork and appropriate interaction of psychiatric and anesthesia teams.