Abstract

Aims and MethodUntil 1999, the most common drug for induction of anaesthesia for electroconvulsive therapy (ECT) in the UK was methohexital. Cessation of production left few choices of induction agent. Increased use of sevoflurane in short procedures suggests that it might be suitable as a sole agent for anaesthesia in ECT. We therefore induced anaesthesia in five consecutive patients undergoing ECT to assess sevoflurane's potential for this use. We recorded vital signs, needle phobia, face-mask toleration, duration of induction, seizure duration and recovery variables.ResultsAnaesthesia was successfully induced in all patients without difficulty. One patient experienced mild hypoxia following the seizure. Seizure duration ranged from 24 to 72 seconds. Recovery times to eye opening and times to ‘ward’ fitness were acceptable.Clinical ImplicationsSevoflurane may be a suitable alternative for induction of anaesthesia for ECT.

Highlights

  • Sevoflurane may be a suitable alternative for induction of anaesthesia for electroconvulsive therapy (ECT)

  • The production of methohexital ceased in September 1999, ending 40 years of its use in anaesthesia for electroconvulsive therapy (ECT), first described by Friedman (1959)

  • The requirements for an anaesthetic agent for ECT are difficult to realise: the drug must possess induction characteristics suited for repeated use, including rapid recovery to street fitness with no confusion following therapy, and have a minimal effect on seizure duration

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Summary

AIMS AND METHOD

Until 1999, the most common drug for induction of anaesthesia for electroconvulsive therapy (ECT) in the UK was methohexital. Cessation of production left few choices of induction agent. Increased use of sevoflurane in short procedures suggests that it might be suitable as a sole agent for anaesthesia in ECT. We induced anaesthesia in five consecutive patients undergoing ECT to assess sevoflurane’s potential for this use. Needle phobia, face-mask toleration, duration of induction, seizure duration and recovery variables

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