Anesthetic efficacy of etomidate, propofol and thiopental sodium during electroconvulsive therapy

Jun, Go Woon; Yang, Hong Seuk; Lee, Yoon Kyung; Seo, Hye Jeong

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2011;6(1):32-36.
Published online January 31, 2011.

Anesthetic efficacy of etomidate, propofol and thiopental sodium during electroconvulsive therapy

Go Woon Jun, Hong Seuk Yang, Yoon Kyung Lee, Hye Jeong Seo

Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. hsyang@amc.seoul.kr

Abstract

BACKGROUND
Electroconvulsive therapy (ECT) is effective for major psychosis and affective disorder. The ideal anesthetics for ECT provide rapid induction and recovery, and they attenuate the adverse effects of ECT. We compared the effects of etomidate, propofol and thiopental sodium during ECT.
METHODS
Nine patients were enrolled in this double blinded cross over design study. The ECT was done 3 times per week for two weeks. We monitored the patients with electrocardiography, pulse oximetry, the bispectral index score and the blood pressure. We recorded the data at the time of arrival to the therapy room, just before ECT and at 1, 2, 3, 4, 5, 7 and 10 minutes after ECT. Hypnosis was induced with 3 mg/kg of thiopental sodium (group T), 1.5 mg/kg of propofol (group P) or 0.15 mg/kg of etomidate (group E). The ECT was done after administering 1 mg/kg of succinylcholine. The duration of seizure were measured after ECT.
RESULTS
There were significantly different durations of motor seizure among the three groups. The duration of EEG seizure in group E was longer than that of group P and group T. The blood pressure and the heart rate of group P were significantly lower than that of the other groups (P < 0.05).
CONCLUSIONS
Compared to thiopental sodium and etomidate, propofol was not associated with clinically significant changes in the duration of seizure and hemodynamic stability. It has a good hypnotic effect and it did not affect the therapeutic efficacy of ECT. Etomidate is effective for patients for achieving a short duration of seizure after ECT is applied.

Key Words: Electroconvulsive therapy, Etomidate, Propofol, Thiopental sodium