بررسي اثر شوك درماني الكتريكي روي فشار داخل چشم در بيماران افسرده

The effect of electroconvulsive therapy on the intra ocular pressure in the patients with major deppression

Background: Electroconvulsive therapy (ECT) is a therapeutic procedure in many of psychiatric disorders such as major depression, mania, acute schizophrenia resistant to medical therapy and many other disorder. For prevention of bone fractures and joint dislocations during tonic-colonic convulsion due to ECT succinylcholine should be used. Intraocular pressure (IOP) rise with succinylcholine as well as tonic-colonic convulsion, TOP decrease with propofol. There is not any paper about the effect of ECT with propofol and succinylcholine on the IOP. Materials and methods: 100 patients 20-40 years old ASA Class 1 or 2 without any ophthalmic disorders were enrolled. All of their medications were discontinued since 48 hours before ECT treatment. The baseline IOP values were determined after tetracaine eye drop application, and then the patients received intravenously atropine 0.5mg, propofol 0.75mg/kg, succinylcholine 1 mg/kg with 1 minute intervals then electrical stimulation applied via a bi-frontal electrode. IOP values measured before any drug administration, before electrical application as well as 1, 5 and 10 minutes after termination of the convulsion. Results: The baseline IOP (14.81±3.6) decreased significantly (13.18±3.55) after propofol but increased significantly (15.52±3.58) after succinylcholine, the IOP also increased significantly 1 minute after convulsion (18.32±3.49) and 5 minutes after convulsion (15.41 ± 3.46), but it returned to the baseline 10 minutes after convulsion (14.68 ±3.57). Conclusion: In conclusion, IOP increased after ECT but the IOP values never reached to pathologic zone at this study, so we regarding to IOP, ECT is a safe procedure in the normal eye patients. Further studies recommended in oldest patients with ophthalmic diseases or at the presents of antipsychotic drugs.