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NCT Number: NCT07824817

Demedetomidine and Remifentanil in Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is a treatment modality that induces therapeutic seizures through electrical stimulation for the management of certain psychiatric disorders. Nearly all ECT procedures are performed under general anesthesia. However, ECT is commonly associated with acute hyperdynamic responses immediately following electrical stimulation, including transient hypertension and tachycardia. These acute hemodynamic changes may pose significant risks, particularly in patients with ischemic heart disease, hypertension, or cerebrovascular disease. Therefore, the hemodynamic response, seizure quality, and recovery profile are critical factors influencing the choice of anesthetic and adjuvant agents. The primary goal of anesthesia for ECT is to maintain hemodynamic stability without compromising seizure duration or quality while ensuring rapid and safe recovery

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Key information

Conditions

Hemodynamic Response

Age range

18 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

About this study

Various pharmacological agents have been investigated in the Electroconvulsive therapy (ECT) procedures. Dexmedetomidine, widely used for sedation, attenuates stress-induced sympathoadrenal responses, reduces postoperative agitation, improves intraoperative hemodynamic stability, and decreases anesthetic requirements during a variety of surgical procedures. As an α2-adrenergic receptor agonist, dexmedetomidine has been shown to attenuate the hyperdynamic response associated with ECT. Remifentanil is a potent μ-opioid receptor agonist characterized by its rapid onset and ultra-short duration of action due to rapid metabolism and elimination. An additional advantage of opioid agonists is their ability to suppress sympathetic responses without increasing the seizure threshold. Consequently, short-acting opioid analgesics such as remifentanil have been recommended as adjuncts during ECT because they improve hemodynamic stability, facilitate rapid recovery, and may prolong seizure duration.

Both dexmedetomidine and remifentanil have been widely used for sedation in anesthesia practice for many years, and several studies have evaluated their use during ECT . Furthermore, the prescribing information for both agents indicates that they are approved for sedation in operating rooms and intensive care units.

The primary objective of this study is to compare the effects of dexmedetomidine and remifentanil on the hemodynamic response in patients undergoing ECT. The secondary objectives are to evaluate seizure duration and recovery characteristics. We anticipate that the findings of this study will contribute to the identification of a safer and more effective anesthetic approach for patients undergoing ECT.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Upremedicated ASA I-II (American Society of Anesthesiologists's physical status) patients,
  • Patients scheduled for six ECT sessions for a variety of psychiatric conditions

Exclusion criteria

  • refusal to participate,
  • age below 18 or above 60 years
  • pregnancy
  • asthma
  • current use of β-adrenergic blockers
  • myocardial infarction within the previous six months
  • atrial fibrillation or atrial flutter,
  • heart block
  • a known personal or family history of hypersensitivity to any of the study drugs

Treatment and study plan

Saline (0.9% NaCl)

Drug

Saline will infused over 10 minutes (total volume: 30 mL)

Dexmedetomidine

Drug

Dexmedetomidine at a dose of 0.5 μg/kg will infused over 10 minutes (total volume: 30 mL)

Remifentanil

Drug

Remifentanil at a dose of 1 μg/kg will infused over 10 minutes (total 30 ml)

Primary outcomes

  1. Hemodynamic response

    Time frame: Before administration of the study medications (t0), and at 1 (t1), 3 (t2), and 10 (t3) minutes after the seizure ended.

    Arterial blood pressure will be recorded at the following times.

Secondary outcomes

  1. seizure duration

    Time frame: up to ten minutes after electrical stimulation

    After anesthesia induction patients will administered electrical stimulation and seizure duration will measured.

  2. Recovery parameters (spontaneous breathing, eye opening, and obeying of verbal commands

    Time frame: After seizure in one hour in operation room

    The time from the end of muscle relaxant administration to the recovery of spontaneous breathing, eye opening, and obeying of verbal commands were recorded.

Study contacts

Contact information is provided by the study sponsor or research team.

Zekine Begeç, Prof.Dr

CONTACT

[email protected]

904223410660 ext. 3112

ülkü özgül, prof. dr

CONTACT

[email protected]

904223410660 ext. 3108

Sponsors and collaborators

Lead sponsor

Inonu University

Other

Registry information

Official study title

Comparison of Three Different Anesthetic Methods in ECT

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Sep 17, 2026
Registry last updated
Sep 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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