Abstract
Introduction:General anesthesia is required for Electroconvulsive Therapy (ECT) and it is usually provided by a hypnotic agent. The seizure duration is important for the treatment, and it is usually accompanied by severe hemodynamic changes. The aim of this study was to compare the effects of sodium thiopental versus Propofol on seizure duration and hemodynamic variables during ECT.Methods:A number of 100 patient-sessions of ECT were included in this randomized clinical trial. The initial hemodynamic state of each patient was recorded. Anesthesia was induced by Sodium thiopental in the 1st group and with Propofol in 2nd group. All the patients received the muscle relaxant succinylcholine. The hemodynamic variables after seizure and seizure duration were recorded. The data were analyzed through SPSS 20 and independent t-test. P<0.05 was considered significant.Results:The mean duration of seizure in the sodium thiopental group was significantly longer than the Propofol group (40.3±16.6 sec versus 32±11.3 sec) (P=0.001). There was no statistically significant difference between the mean energy level applied in the two groups (20.5±3.81 joules in the sodium thiopental versus 20.2±3.49 joules in the Propofol group). The mean systolic and diastolic blood pressure at all times after seizure and mean heart rate at 3 and 5 minutes after seizure were significantly lower in Propofol than sodium thiopental groups.Discussion and Conclusion:Propofol provides a more stable hemodynamic state for the ECT procedures, and its use is highly preferred over sodium thiopental in patients with cardiovascular disease.
Highlights
General anesthesia is required for Electroconvulsive Therapy (ECT) and it is usually provided by a hypnotic agent
The mean duration of seizure in the sodium thiopental group was significantly longer than the Propofol group (40.3±16.6 sec versus 32±11.3 sec) (P=0.001)
The mean systolic and diastolic blood pressure at all times after seizure and mean heart rate at 3 and 5 minutes after seizure were significantly lower in Propofol than sodium thiopental groups
Summary
General anesthesia is required for Electroconvulsive Therapy (ECT) and it is usually provided by a hypnotic agent. ECT is considered one of the most effective treatments for major depression and unlike its alternative physical therapies, acts as a rapid-acting regimen for life-threatening psychiatric disorders. It continues to be a preferred modality among the modern treatments.The ECT treatment causes significant hemodynamic changes including tachycardia and hypertension which can be hazardous for some patients. The ideal anesthetic medication for ECT should provide a rapid onset and recovery without altering the seizure duration while maintaining a stable hemodynamic state (Bauer, Hageman, Dam, Báez, Bolwig, & Roed, 2009; Dogan, Senoglu, Yildiz, Coskuner, & Ugur N, 2011; Patel, Gorst-Unsworth, Venn, Kelley & Yoav, 2006; Tan & Lee, 2009). Sodium thiopental usually does not have a rapid recovery, but Propofol provides a rapid onset and www.ccsenet.org/gjhs
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