Investigating the effects of ketofol and the combination of remifentanil and propofol on the duration of the convulsion and haemodynamics of psychotic patients in electroconvulsive therapy: A randomised clinical study

Abstract

Introduction: Electroconvulsive therapy (ECT) is a method of treatment for patients suffering from depressive disorders, bipolarity, and schizophrenia and is accompanied by hyperdynamic responses. This study aimed to find intravenous anaesthesia with profound effects but fewer side effects. Materials and Methods: This study was an interventional clinical trial, in which 35 patients were categorised into three groups each being treated in three sessions (105 cases in total). Group A received distilled water + propofol 1mg/kg, Group B received remifentanil 1 µg/kg + propofol 1mg/kg and Group C received ketamine + propofol (ketofol) 1 with the dose of 1 mg/kg. Then, the patients were investigated in terms of hemodynamic changes and recovery time in the first 10 min. Results: There were no significant differences in the three groups of the study in terms of the patients' heart rate, blood pressure and oxygen saturation percentage (P = 0.598, P = 0.283 and P = 0.172, respectively). However, there was a significant difference (P = 0.0001) amongst the three groups in terms of recovery time as Group C (ketofol) had the lowest recovery time and Group B (remifentanil + propofol) had the highest recovery time. Moreover, there was a significant difference across the three groups regarding the agitation score showing that sole propofol resulted in the lowest amount of agitation in the three groups (P = 0.026). The highest amount belonged to Group C. Conclusions: The ketofol compound had the lowest recovery time, and the remifentanil + propofol compound had the highest recovery time in ECT candidate patients. Sole propofol caused the lowest amount of agitation and ketofol caused the highest amount of agitation in the patients.