Rocuronium-sugammadex as an alternative muscle relaxant to succinylcholine in electroconvulsive therapy: A meta-analysis

Table 2 Study description

Ref.	Study design	Patients/ECT sessions	R dose	SG dose	SCC dose	Induction agent	Key outcomes measured
Hoshi et al[11]	Small observational case series, non-blinded muscle relaxant selection	5 patients (every patient 3 with SCC and 4 with R + SCC)	0.6 mg/kg	16 mg/kg	1 mg/kg	Propofol 1.0 mg/kg	T1 10% and 90% recovery, time to first spontaneous breath, eye opening, seizure duration, adverse effects
Kadoi et al[12]	Clinical study, lottery system for sugammadex dose (non-blinded sugammadex administration)	17 patients(3 session with different dose of SG and 4 sessions of SCC)	0.6 mg/kg	16 mg/kg, 8 mg/kg, or 4 mg/kg	1 mg/kg	Propofol 1.0 mg/kg	T1 10% and 90% recovery, seizure duration, time to first spontaneous breath, adverse effects
Saricicek et al[13]	Randomized	45 patients	0.3 mg/kg	4 mg/kg	1 mg/kg	Propofol 1 mg/kg	Myalgia VAS, headache VAS, time to T1, T2, motor seizure duration
Koksal et al[14]	Randomized, double-blind (for drug preparation)	16 patients	0.6 mg/kg	4 mg/kg	1 mg/kg	Propofol 2 mg/kg	Spontaneous breathing time, eye opening time, time for obeying instructions, motor seizure duration, MAS and MAS 9 timing, T1 0% and T1 90% times, vital signs, side effects
Oflezer et al[15]	Single-center retrospective observational study	134 patients	0.3 mg/kg	2 mg/kg	0.5 mg/kg	Propofol 1 mg/kg	EEG seizure duration, motor seizure modification, CGI-I score, adverse effects, vital signs
Moutaoukil et al[16]	Small observational case series (prospectively collected)	4 patients	0.3 mg/kg	4 mg/kg	0.5 mg/kg	Propofol 1-1.5 mg/kg	Motor seizure modification, time to spontaneous breathing, time to eye opening, agitation, myalgia, headache, nausea/vomiting, EEG seizure duration
Karaca Bent et al[17]	Single-center observational cohort study (prospective collection, retrospective analysis)	100 adult patients	0.4 mg/kg	2 mg/kg	1 mg/kg	Propofol 1 mg/kg	Spontaneous breathing time, spontaneous eye opening, seizure duration, vital signs (BP, HR, SpO2)

ECT: Electroconvulsive therapy; SCC: Succinylcholine; R: Rocuronium; SG: Sugammadex; T1: Time to spontaneous respiration; T2: Time to eye-opening; VAS: Visual Analogue Scale; MAS: Modified Ashworth Scale; CGI-I: Global Impression Improvement; EEG: Electroencephalography; BP: Blood pressure; HR: Heart rate.