title: Comparison of enflurane and propofol in electroconvulsive therapy, a randomized crossover open preliminary study on seizure duration and anaesthetic recovery.
abstract: OBJECTIVE
  Electroconvulsive therapy (ECT) is commonly used for treatment of depression, mania and affective disorders. Anaesthetics for general anaesthesia during ECT should have rapid onset, rapid emerge, not interfere with seizure activity and not shorten seizure duration. The aim of this study is to compare effects of enflurane, a pro-convulsive anaesthetic agent, and propofol on seizure durations, postictal suppression index and recovery times during electroconvulsive therapy.
  
  
  METHODS
  Unpremedicated subjects were divided into two groups according to induction of anaesthesia. Patients were induced for ECT with 5% enflurane in group E and 1.2mg.kg(-1) propofol in group P until loss of consciousness. The durations of electroencephalogram (EEG) and motor seizures, postictal suppression index, time to spontaneous breathing, duration of eye opening, and obeying commands were recorded.
  
  
  RESULTS
  There was no statistically significant difference between the groups regarding motor and EEG seizure times and postictal suppression index on the EEG records. Recovery times (times of starting spontaneous breathing, eye opening, and obeying command) were significantly shorter in group E compared to group P. No nausea or vomiting were observed and no ECG abnormality was noted except transient sinus bradycardia and sinus tachycardia.
  
  
  CONCLUSIONS
  Although sufficient seizure for the treatment was provided during enflurane anaesthesia, any additional benefit was not revealed regarding seizure times or postictal suppression index when compared to propofol anaesthesia. On the other hand, recovery times after enflurane anaesthesia were shorter than propofol anaesthesia. However, there is still a need for further study in different ETCO(2) levels.
authors.affiliation: Anaesthesiology and Intensive Care, Medical School, Bezmialem Vakif University, Istanbul, Turkey. drzdogan@yahoo.com
authors.forename: Zafer
authors.initials: Z
authors.lastname: Dogan
authors.forename: Nimet
authors.initials: N
authors.lastname: Senoglu
authors.forename: Huseyin
authors.initials: H
authors.lastname: Yildiz
authors.forename: Ismail
authors.initials: I
authors.lastname: Coskuner
authors.forename: Nadiye
authors.initials: N
authors.lastname: Ugur
authors.forename: Elif
authors.initials: E
authors.lastname: Biter
authors.forename: Hafize
authors.initials: H
authors.lastname: Oksuz
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004565:Electroconvulsive Therapy; D004737:Enflurane / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D012640:Seizures / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D004737:Enflurane; D015742:Propofol