title: Ketofol in electroconvulsive therapy anesthesia: two stones for one bird.
abstract: OBJECTIVE
  Propofol and ketamine have become progressively popular in electroconvulsive therapy (ECT) anesthesia, although propofol shortened seizure duration and ketamine might cause cardiotoxicity, psychotic episodes, and delayed recovery. Ketofol is a combination of ketamine and propofol, and the current study was designed to evaluate the effect of ketamine, propofol, and ketofol on hemodynamic profile, duration of seizure activity, and recovery times in patients undergoing ECT.
  
  
  METHODS
  Ninety patients (44 women, mean age 27.8 ± 7.2 years) in one ECT session were enrolled and randomized to the propofol, ketamine, or ketofol group. Hemodynamic profile duration of seizure activity and recovery times were recorded.
  
  
  RESULTS
  Motor seizure duration in the propofol group was significantly decreased compared to other groups (p < 0.001), whereas spontaneous breathing time in the ketamine group statistically increased compared to the propofol group (p = 0.001), and also eye-opening time (p < 0.001) and obeying-command time (p < 0.001) was significantly increased in the ketamine group compared to other groups. Heart rate (HR) at induction (ketamine 91.2 ± 13.6 vs. propofol 77 ± 13.4 and ketofol 79.9 ± 15.6; p < 0.013; p < 0.08, respectively) was statistically significantly increased in the ketamine group compared to other groups, and HR at the third minute (ketamine 92 ± 12.9 vs. propofol 79.4 ± 9.3 and ketofol 81.5 ± 14.2; p < 0.012, p < 0.048) was also statistically significantly increased in ketamine group compared to other groups.
  
  
  CONCLUSIONS
  The ketofol 1:1 mixture is associated with longer mean seizure time than propofol, and shorter mean recovery times than ketamine, with better hemodynamic stability, without any important side effects in ECT anesthesia.
authors.affiliation: Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Yenişehir Yerleşkesi, 63300, Şanlıurfa, Turkey. sabanyalcin@yahoo.com
authors.forename: Saban
authors.initials: S
authors.lastname: Yalcin
authors.forename: Harun
authors.initials: H
authors.lastname: Aydoğan
authors.forename: Salih
authors.initials: S
authors.lastname: Selek
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kucuk
authors.forename: Hasan Husnu
authors.initials: HH
authors.lastname: Yuce
authors.forename: Fatih
authors.initials: F
authors.lastname: Karababa
authors.forename: Tekin
authors.initials: T
authors.lastname: Bilgiç
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D062186:Arterial Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004338:Drug Combinations; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007649:Ketamine / Q000009:adverse effects; D008297:Male; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D015742:Propofol / Q000009:adverse effects; D018401:Sample Size; D012640:Seizures / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D007649:Ketamine; D015742:Propofol