title: Sevoflurane versus propofol for electroconvulsive therapy: effects on seizure parameters, anesthesia recovery, and the bispectral index.
abstract: OBJECTIVE
  In this prospective randomized cross-over study we compare the effects of sevoflurane versus propofol for electroconvulsive therapy (ECT) anesthesia.
  
  
  METHODS
  Twenty four patients (ASA I-III, 18-65 years old) receiving ECT three times per week were included. Anesthesia was induced with either propofol (0.75 mg/kg iv) or 5% sevoflurane in 100% oxygen. Consecutive ECT sessions followed a 2 × 2 crossover design and a 2-day washout period until the 10th ECT. Intravenous succinylcholine (1 mg/kg) was administered while bispectral index (BIS) values were ≤60%.
  
  
  RESULTS
  Electromyogram and electroencephalogram seizure duration, postictal suppression index, BIS values, mean arterial blood pressure (MAP), heart rate, times to start of spontaneous respiration, eye opening, understanding verbal commands, and side effects were compared. No differences were found between the regimens for seizure activity and recovery. At the end of ECT, MAP was higher with sevoflurane. Although BIS values were higher after sevoflurane, no differences between the regimens were found in terms of the need of muscle relaxants and in hypnosis levels.
  
  
  CONCLUSIONS
  Sevoflurane (5%) may be an effective alternative to propofol for induction of anesthesia for ECT.
authors: Department of Anesthesiology and Reanimation, Private Deniz Hospital, İzmir, Turkey.
authors: Melekşah
authors: M
authors: Pekel
authors: Department of Anesthesiology and Reanimation, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors: Nadide Aysun
authors: NA
authors: Postaci
authors: Department of Anesthesiology and Reanimation, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors: İsmail
authors: İ
authors: Aytaç
authors: Department of Anesthesiology and Reanimation, Bursa Şevket Yılmaz Education and Research Hospital, Bursa, Turkey.
authors: Derya
authors: D
authors: Karasu
authors: İstanbul Forensic Medicine Institute Sixth Forensic Medicine Council, İstanbul, Turkey.
authors: Hüseyin
authors: H
authors: Keleş
authors: Department of Anesthesiology and Reanimation, Doktor Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors: Özlem
authors: Ö
authors: Şen
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University Ankara, Turkey.
authors: Bayazit
authors: B
authors: Dikmen
authors: Department of Psychiatry, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors: Erol
authors: E
authors: Göka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia; D018686:Anesthetics, Intravenous; D018592:Cross-Over Studies; D004565:Electroconvulsive Therapy; D004569:Electroencephalography; D006801:Humans; D008738:Methyl Ethers; D008875:Middle Aged; D015742:Propofol; D011446:Prospective Studies; D012640:Seizures; D000077149:Sevoflurane; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol
keywords: Electroconvulsive therapy; anesthesia; bispectral index; propofol; sevoflurane