title: Comparison of propofol and thiopental as anesthetic agents for electroconvulsive therapy: a randomized, blinded comparison of seizure duration, stimulus charge, clinical effect, and cognitive side effects.
abstract: OBJECTIVE
  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.
authors.affiliation: Center of Psychiatry, Rigshospitalet, Copenhagen Ø, Denmark. jeanett.bauer@gmail.com
authors.forename: Jeanett
authors.initials: J
authors.lastname: Bauer
authors.forename: Ida
authors.initials: I
authors.lastname: Hageman
authors.forename: Henrik
authors.initials: H
authors.lastname: Dam
authors.forename: Armando
authors.initials: A
authors.lastname: Báez
authors.forename: Tom
authors.initials: T
authors.lastname: Bolwig
authors.forename: Jakob
authors.initials: J
authors.lastname: Roed
authors.forename: Niels Vidiendal
authors.initials: NV
authors.lastname: Olsen
authors.forename: Martin Balslev
authors.initials: MB
authors.lastname: Jørgensen
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000771:Anesthesia, Intravenous / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009483:Neuropsychological Tests; D015742:Propofol / Q000009:adverse effects; D012640:Seizures / Q000503:physiopathology; D013874:Thiopental / Q000009:adverse effects; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D013874:Thiopental; D015742:Propofol