title: Management of poor postictal suppression during electroconvulsive therapy with propofol anesthesia: a report of two cases.
abstract: There is increasing evidence that a greater degree of postictal suppression (the abruptness and magnitude of the EEG voltage drop at the end of the seizure) may be associated with better clinical response to electroconvulsive therapy. Retrospective studies have shown better postictal suppression when propofol is used for induction rather than the more commonly used methohexital. We report two patients in whom poor postictal suppression was rectified by switching from methohexital to propofol. The clinical significance of this improvement in postictal suppression is unclear, and prospective studies will be needed to clarify any clinical benefits.
authors: Geropsychiatry Section (116A), James A. Haley VA Hospital, University of South Florida College of Medicine, 13000 Bruce B. Downs BLVD, Tampa, FL 33612, USA. jonathan.stewart1@va.gov
authors: Jonathan T
authors: JT
authors: Stewart
mesh_terms: D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008723:Methohexital; D008875:Middle Aged; D015742:Propofol; D012640:Seizures / Q000503:physiopathology; D013874:Thiopental; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D008723:Methohexital; D013874:Thiopental; D015742:Propofol