Rocuronium-Sugammadex Decreases the Severity of Post-Electroconvulsive Therapy Agitation

A 51-year-old male patient with a diagnosis of refractory major depressive disorder and unresponsive to antidepressants underwent 8 sessions of electroconvulsive therapy (ECT) every 48 hours. Succinylcholine was used for muscle relaxation until the sixth ECT session, and midazolam was administered for severe emergence agitation that recurred after each session. In the sixth ECT session, rocuronium, 0.4 mg/kg, was used for muscle relaxation and sugammadex, 2 mg/kg, for reversal of muscle paralysis. Subsequently, a clear decrease in post-ECT agitation was observed. We suggest that this combination might be a safe and effective alternative to succinylcholine for post-ECT agitation.