Sevoflurane as an alternative anaesthetic for electroconvulsive therapy.
OBJECTIVE
The aim of this study was to investigate the effects of sevoflurane and propofol used in electroconvulsive therapy (ECT) on hemodynamic variables and duration of seizure activity and recovery profiles.


METHODS
Sixteen patients who were not premedicated, with a mean age 27.1 years, were enrolled in this prospective open trial, receiving a total of 64 ECT treatments. Each patient was given the following 2 anesthetic regimens in random order: In group S, anesthesia was induced with 7% sevoflurane in 100% oxygen at 6 L min fresh gas flow until the loss of consciousness and 1.5 mg kg propofol in group P. Adequate muscle relaxation was achieved with suxamethonium, 1.0 - 1.2 mg kg. Noninvasive mean arterial pressure (MAP) and heart rate (HR) values, duration of motor seizure activity, and recovery times were recorded.


RESULTS
The mean motor seizure duration was significantly longer with sevoflurane (mean [SD]: 43.09 [16.6] s) than with propofol (28.91 [7.9] s; P < 0.05). The MAP 1 minute and 10 minutes after ECT (101.25 [7.5] mm Hg and 100.16 [11.0] mm Hg, respectively) was significantly increased compared with before ECT (94.56 [6.9] mm Hg) in sevoflurane group (P < 0.05). Time to spontaneous breathing, eye opening and obeying commands, and changes in MAP and HR during and after ECT were similar in both regimens.


CONCLUSIONS
Induction with 7% sevoflurane allows prolonged duration of motor seizures in ECT. We concluded that induction of anesthesia with sevoflurane inhalation is a reasonable alternative for patients undergoing ECT.
Toprak
Hüseyin I
HI
Department of Anaesthesiology, Medical School of Inonu University, Malatya, Turkey. hilksen@inonu.edu.tr
Gedik
Ender
E
Begeç
Zekine
Z
Oztürk
Erdoğan
E
Kaya
Burhanettin
B
Ersoy
Mehmet O
MO
D000293:Adolescent; D000328:Adult; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D004565:Electroconvulsive Therapy; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000627:therapeutic use*; D015742:Propofol / Q000627:therapeutic use; D011446:Prospective Studies; D000077149:Sevoflurane; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol