title: The comparative effects of sevoflurane and methohexital for electroconvulsive therapy.
abstract: The standard anesthetic agent for electroconvulsive therapy (ECT) has been methohexital. We compared sevoflurane, a short-acting halogenated anesthetic, to methohexital for induction in ECT. Twelve subjects received sevoflurane or methohexital on alternating treatment days. Seizure duration, time to administering ECT, emergence and recovery, as well as several hemodynamic measures were recorded. A total of 69 treatments were analyzed. When sevoflurane was used, seizure durations recorded by observation and by EEG, were shorter by 10 and 23 seconds, respectively. With sevoflurane, seizure duration remained, however, within a clinically acceptable range. Methohexital allowed faster administration of ECT and discharge from the recovery room (3.8 vs. 6.2 minutes and 40.8 vs. 47.0 minutes, respectively). No difference in the post-ECT hemodynamic changes was found between the two treatments. We conclude that, when indicated, sevoflurane could provide a suitable alternative treatment option to methohexital, but some limitations, including shortened seizure duration and potential side effects, should be kept in mind.
authors.affiliation: Department of Psychiatry, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa 52242, USA.
authors.forename: Chadi A
authors.initials: CA
authors.lastname: Calarge
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Crowe
authors.forename: Samir D
authors.initials: SD
authors.lastname: Gergis
authors.forename: Stephan
authors.initials: S
authors.lastname: Arndt
authors.forename: Robert P
authors.initials: RP
authors.lastname: From
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004565:Electroconvulsive Therapy; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008723:Methohexital / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D008738:Methyl Ethers / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D008875:Middle Aged; D012640:Seizures / Q000209:etiology*; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D008723:Methohexital