A COMPARISON OF PROPOFOL AND PROPOFOL-KETAMINE EFFECTS ON HEMODYNAMIC RESPONSES DURING ELECTROCONVULSIVE THERAPY (ECT)

Abstract

Objective : Electroconvulsive Therapy (ECT) is the most effective treatments in curing the major depression and psychiatric disease. Since propofol and ketofol (Propofol-Ketamine) are common medicines in ECT, this study aims to compare the effect of these medicines on seizure duration and hemodynamic responses. Methods: This study was a clinical trials with a sample volume of 25 patients (50 patients meeting), classified based on ASA 1 and 2, 20-58 years old, who were candidate for ECT at Ebn Sina hospital in Bandar Abbas during 2014-2015. All of the patients and their first degree relatives were satisfied to participate in the study. Patients with high blood pressure history, diabetes, renal failure, neuro-vascular and heart disease were excluded from the study. Initial systolic and diastolic blood pressure and heart rate of all participants were recorded. In the first session, they randomly received propofol (2 mg/kg), atropine (0.5 mg), Esculin (0.5 – 1.0 mg) and in the next session ketamine (0.8 mg/kg), propofol (2 mg/kg), Esculin (0.5 – 1.0 mg), atropine (0.5 mg) and ECT with 10 -15 joule. Hemodynamic parameters of all participants again measured and registered at 1, 3 and 5 minutes after convulsion. Data was analyzed with SPSS software using descriptive statistical tests and independent T-test. Results: The average duration of convulsive anesthesia was 32.76 and 32.72 seconds for propofol and ketofol, respectively, which was statistically no significant difference (P = 0.99). Hemodynamic variations in patients were higher for propofol compared to ketofol and these variations were statistically meaningful in 3rd minute for SBP, 1st and 5th minute for DBP and 3rd minute for heart rate. (P<0.05) Discussion: Based on effect of propofol and ketofol(Propofol-Ketamine) on hemodynamic parameters and convulsive duration, ketofol is more recommended for anesthesia in ECT.