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

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