scholarly journals Comparison of Thiopentone sodium Vs Propofol as an Anaesthetic agent in Modified Electroconvulsive Therapy

Author(s):  
Sonali Joshi ◽  
Author(s):  
Vigil Peter ◽  
Sumesh Mathew ◽  
Tom Thomas

Background: The use of electroconvulsive therapy (ECT) as a treatment modality has increased over the recent years. This is largely due to the use of general anaesthetics, which reduces the physical and psychological trauma associated with the procedure. We attempted to compare the hemodynamic variations and recovery characteristics, along with their effect on seizure quality in patients induced with Thiopentone /Propofol, for Modified ECT.Methods: This was a prospective, randomised controlled study, involving 80 patients. Patients in group 1 received Thiopentone 5 mg/kg, while patients in group 2 received Propofol 1 mg/kg. The hemodynamic status and recovery status were monitored in both the groups for the first thirty minutes. Seizural duration were also recorded. Data was analysed using Students t-test and Pearson Chi-square test.Results: The induction time as well as recovery time was found to be significantly lesser (p <0.05) in the propofol group. The hemodynamic response to was blunted and returned to baseline levels within 10-15 minutes after ECT in the propofol group, whereas it persisted even after 30 minutes in the thiopentone group. There was however, no significant difference in the duration of the seizural activity(p> 0.05).Conclusions: The quick and smooth induction, transient changes in hemodynamics, rapid recovery profile and minimal effects on the seizure quality altogether makes Propofol the preferred anaesthetic agent in Modified ECT.


2020 ◽  
Author(s):  
Lauren Alexander ◽  
Kevin Malone ◽  
Eimear Counihan ◽  
Jennifer Kennedy ◽  
Darren Roddy ◽  
...  

2019 ◽  
Author(s):  
Xue Jiang ◽  
Qin Xie ◽  
Lian-Zhong Liu ◽  
Bao-Liang Zhong ◽  
Liang Si ◽  
...  

Abstract Background: To explore the clinical efficacy and safety of modified electroconvulsive therapy (MECT) in the treatment of elderly patients with refractory depression. Methods : A total of 43 older patients (18 male and 25 female) with refractory depression were enrolled in our study from March 2014 to February 2015, with the average age of 65±4.8 years old. Modified electroconvulsive therapy (MECT) was performed in these patients after physical examinations and anesthesia procedures. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to assess the efficacy of MECT, and Wechsler Memory Scale (WMS) and mini mental state examination (MMSE) were used to evaluate the memory ability and cognitive function. The preoperative, intraoperative and postoperative care were conducted in patients accompanied by physical diseases. Results: The rate of efficacy was calculated as 67.44% after 4 weeks of MECT treatment. Our results showed HAMA and HAMD scores after 2 weeks of MECT treatment were significantly lower than that before treatment (P<0.05), and the differences were more significant after 4 weeks of MECT treatment (P<0.01). Compared with before treatment, the scores of memory quotient and immediate memory of WMS decreased significantly after 1 week of treatment (P<0.05). However, these events were not be presented with the progress of treatment, except for after 2 weeks of treatment. Our results demonstrated that compared with before treatment, the scores of MMSE significantly increased significantly after 4 weeks of treatment (P<0.05). There were no serious adverse events in all patients, including cardiovascular and cerebrovascular events. Among them, 7 patients had transient blood pressure rise and slight headache, which were relieved spontaneously after resting. Conclusion: MECT is an effective, well tolerated and safe method for the treatment of older patients with refractory depression, which is temporary and reversible for cognitive impairment. MECT can be recommended for the treatment of these patients after conducting effective risk control of comorbid somatic diseases.


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