Abstract
OBJECTIVES: To compare propofol and thiopental as anesthetic agents for electroconvulsive therapy (ECT) with respect to seizure duration, stimulus charge, clinical effect, and cognitive side effects.
METHODS: Randomized, blinded study of 62 depressed patients treated with bilateral ECT. Algorithm-based charge dosing was used.
RESULTS: The mean seizure duration of the patients in the thiopental group was 36.3 seconds versus 25.7 seconds in the propofol group (P = 0.001). The charge per treatment was 79.5 mC in the thiopental group versus 109.8 mC in the propofol group (P = 0.026). Sixteen patients in the propofol group (52%) reached the highest electrical dose versus 8 patients (26%) in the thiopental group (P = 0.014). No difference in response to treatment or number of treatments was observed. The mean score on Mini-Mental State Examination (MMSE) was 28.9 in the thiopental group versus 26.8 in the propofol group (P = 0.014). However, age distribution of patients completing the study differed between the groups.
CONCLUSIONS: Propofol significantly decreases seizure duration without significant difference in the clinical outcome. Using the employed treatment algorithm, patients anesthetised with propofol received higher electrical charge. Mini-Mental State Examination scores suggest that this results in more severe cognitive side effects. Results, however, might be confounded by the differences in age distribution in the groups.
| Original language | English |
|---|---|
| Journal | Journal of Electroconvulsive Therapy |
| Volume | 25 |
| Issue number | 2 |
| Pages (from-to) | 85-90 |
| Number of pages | 6 |
| ISSN | 1095-0680 |
| DOIs | |
| Publication status | Published - Jun 2009 |
Keywords
- Adult
- Aged
- Algorithms
- Anesthesia, Intravenous
- Anesthetics, Intravenous
- Cognition Disorders
- Double-Blind Method
- Electroconvulsive Therapy
- Female
- Humans
- Male
- Middle Aged
- Monitoring, Physiologic
- Neuropsychological Tests
- Propofol
- Seizures
- Thiopental
- Young Adult