title: Relationship between blood levels of propofol and recovery of memory in electroconvulsive therapy.
abstract: OBJECTIVE
  Memory impairment is a potential major adverse effect of electroconvulsive therapy (ECT). Some reports have suggested that propofol, an intravenous anesthetic widely used for general anesthesia in ECT, can minimize adverse effects on memory and cognitive function following ECT. The relation between propofol blood level during ECT and memory impairment after the procedure is unknown. We aimed to determine the relation between predicted blood level of propofol administered by target-controlled infusion during ECT and memory impairment after the procedure.
  
  
  METHODS
  Thirty-six patients who underwent a total of 260 series of ECT were enrolled as subjects. Anesthesia was induced with intravenous injection of propofol with a target-controlled infusion pump for predicting blood levels. Orientation and memory testing were performed after completion of ECT. In a subsequent analysis, subjects were divided into early memory recovery (n = 195) and late memory recovery (n = 65) groups. Likewise, for orientation testing,subjects were divided into early recovery (n = 193) and late recovery (n = 67) groups. In both groups, predicted blood propofol levels, total propofol dose, and other variables, such as number of ECT treatments, stimulus energy volume, and spike and slow wave time, were determined for comparison.
  
  
  RESULTS
  Predicted blood propofol levels and propofol total dose were significantly higher in the early memory recovery group, while no significant differences were observed for the other variables. As for orientation, there were no significant differences between the early and late orientation recovery groups.
  
  
  CONCLUSIONS
  Our data shows that the predicted blood propofol levels and the total dose influences memory impairment after the ECT.
authors: Department of Neuropsychiatry, Aichi Medical University, Aichi, Japan.
authors: Yasuhiko
authors: Y
authors: Imashuku
authors: Kousuke
authors: K
authors: Kanemoto
authors: Masanori
authors: M
authors: Senda
authors: Momoyo
authors: M
authors: Matsubara
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects* / Q000502:physiology; D008569:Memory Disorders / Q000097:blood / Q000209:etiology* / Q000523:psychology; D008875:Middle Aged; D015742:Propofol / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol
keywords: electroconvulsive therapy; memory impairment; predicted blood level; propofol; target controlled infusion