ArticleWorld journal of psychiatry2026
Rocuronium-sugammadex as an alternative muscle relaxant to succinylcholine in electroconvulsive therapy: A meta-analysis.
Article in World journal of psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundElectroconvulsive therapy (ECT) requires optimal muscle relaxation, which is conventionally achieved with succinylcholine (SCC) despite its adverse effects. In this context, rocuronium-sugammadex (RS) has emerged as a potential alternative, but its comparative efficacy remains uncertain. Hence, this meta-analysis evaluated the recovery times, seizure duration, and safety of these agents in ECT.
aimTo compare the recovery times, seizure duration, and side effect profiles of RS and SCC in ECT.
methodsPubMed, EMBASE, and Cochrane Library (from inception to June 2025) were systematically searched for randomized and observational studies comparing RS with SCC in ECT. The primary outcomes were seizure duration (motor/electroencephalogram) and recovery time, and the secondary outcomes included adverse events (
resultsThis meta-analysis included 7 studies involving 250 observations of patients who received RS and 282 sessions in which patients received SCC. Regarding seizure duration required for effective ECT, RS was associated with a longer duration (SMD: 0.43, 95%CI: 0.15-0.70,
conclusionRS is a feasible alternative to SCC for ECT, with acceptable recovery and fewer side effects without affecting the seizure duration. However, larger high-quality randomized controlled trials are necessary to statistically substantiate these findings and assess the long-term outcomes.
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