title: The effect of adjuvant remifentanil with propofol or thiopentone on seizure quality during electroconvulsive therapy.
abstract: In order to optimise outcome to Electro Convulsive therapy (ECT), there has been a trend to utilise remifentanil as an adjunct to standard intravenous induction agents. This has allowed a reduction in the dose of anaesthetic agent, and usually an improved response to stimulation. However there have been no previous studies to ascertain whether this improvement is simply as a result of the reduced dose of anaesthetic agent or whether remifentanil itself might possess epileptogenic properties. This retrospective case-controlled study examined ECT outcomes, determined by EEG quality analysis, in patients who received ECT with or without remifentanil, where there was no dose reduction in the anaesthetic agent. There were no improvements seen in the measurements of any EEG parameter, including seizure duration. These observations suggest that remifentanil does not possess any intrinsic pro-convulsant activity and that any improvement in outcome seen with its use is as a result of dose reduction in the IV anaesthetic agent.
authors.affiliation: Royal North Shore Hospital, Sydney.
authors.forename: R
authors.initials: R
authors.lastname: MacPherson
authors.affiliation: Royal North Shore Hospital.
authors.forename: M
authors.initials: M
authors.lastname: Marroquin-Harris
authors.affiliation: Department of Psychiatry, University of New South Wales.
authors.forename: V
authors.initials: V
authors.lastname: Gálvez
authors.affiliation: Department of Psychiatry, University of New South Wales.
authors.forename: P
authors.initials: P
authors.lastname: Tor
authors.forename: C
authors.initials: C
authors.lastname: Loo
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004565:Electroconvulsive Therapy; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil; D012189:Retrospective Studies; D012640:Seizures / Q000628:therapy*; D013874:Thiopental / Q000008:administration & dosage*
chemical_list: D010880:Piperidines; D013874:Thiopental; D000077208:Remifentanil; D015742:Propofol
keywords: Electroconvulsive therapy; remifentanil