Abstract
BackgroundSeizure duration in electroconvulsive therapy (ECT) is positively related with patients’ outcome. This study sought to investigate the impact of anesthetic management on seizure duration, and the impact of selected drugs (theophylline, remifentanil, S-ketamine) on seizure duration.MethodsRetrospective analysis of all patients undergoing ECT at our institution from January 2011 to April 2012 was performed based on electronic medical chart and review of existing quality improvement data. Patient data (N = 78), including gender, age, height, weight, and administered drugs, energy levels, and electroencephalic seizure duration were analyzed. Statistical analysis was performed using a generalized linear model.ResultsA total of 78 patients (male = 39, female = 39, age 51 ± 12 years) were included. Average number of session was 10 ± 6 (1–30). In our patient population, theophylline administration was the only parameter, which significantly prolonged seizure duration, whereas S-ketamine, remifentanil, thiopental, age, sex, session or energy level had no significant effect.ConclusionTheophylline can be a useful adjunct for patients with inadequate seizure duration. If there is a concomitant beneficial effect on patients’ outcome needs to be investigated in further studies.
Highlights
Seizure duration in electroconvulsive therapy (ECT) is positively related with patients’ outcome
Several studies thereby focused on drug management, for example S-ketamine was shown to lead to longer motor seizure duration than metohexital [6]
This study showed that in our patient population only theophylline significantly prolonged seizure duration whereas other drugs that are commonly used for ECT like S-ketamine, remifentanil, thiopental had no significant effect on EEG seizure duration
Summary
Seizure duration in electroconvulsive therapy (ECT) is positively related with patients’ outcome. This study sought to investigate the impact of anesthetic management on seizure duration, and the impact of selected drugs (theophylline, remifentanil, S-ketamine) on seizure duration. Today electroconvulsive therapy (ECT) is one of the most effective treatments for patients with major depression and persistent psychosis [3] and is performed under general anesthesia with muscle relaxation. Since suicide is a leading cause of death among psychiatric patients, and Several studies thereby focused on drug management, for example S-ketamine was shown to lead to longer motor seizure duration than metohexital [6]. When etomidate was given for induction of anesthesia longer motor and electroencephalographic (EEG) seizures were observed compared to propofol [7]. Aminophyllines like theophylline increase seizure duration [3]
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