TY - JOUR
T1 - Comparison of propofol and thiopental as anesthetic agents for electroconvulsive therapy: a randomized, blinded comparison of seizure duration, stimulus charge, clinical effect, and cognitive side effects
AU - Bauer, Jeanett
AU - Hageman, Ida
AU - Dam, Henrik
AU - Báez, Armando
AU - Bolwig, Tom
AU - Roed, Jakob
AU - Olsen, Niels Vidiendal
AU - Jørgensen, Martin Balslev
N1 - Keywords: Adult; Aged; Algorithms; Anesthesia, Intravenous; Anesthetics, Intravenous; Cognition Disorders; Double-Blind Method; Electroconvulsive Therapy; Female; Humans; Male; Middle Aged; Monitoring, Physiologic; Neuropsychological Tests; Propofol; Seizures; Thiopental; Young Adult
PY - 2009
Y1 - 2009
N2 - OBJECTIVES: To compare propofol and thiopental as anesthetic agents for electroconvulsive therapy (ECT) with respect to seizure duration, stimulus charge, clinical effect, and cognitive side effects. METHODS: Randomized, blinded study of 62 depressed patients treated with bilateral ECT. Algorithm-based charge dosing was used. RESULTS: The mean seizure duration of the patients in the thiopental group was 36.3 seconds versus 25.7 seconds in the propofol group (P = 0.001). The charge per treatment was 79.5 mC in the thiopental group versus 109.8 mC in the propofol group (P = 0.026). Sixteen patients in the propofol group (52%) reached the highest electrical dose versus 8 patients (26%) in the thiopental group (P = 0.014). No difference in response to treatment or number of treatments was observed. The mean score on Mini-Mental State Examination (MMSE) was 28.9 in the thiopental group versus 26.8 in the propofol group (P = 0.014). However, age distribution of patients completing the study differed between the groups. CONCLUSIONS: Propofol significantly decreases seizure duration without significant difference in the clinical outcome. Using the employed treatment algorithm, patients anesthetised with propofol received higher electrical charge. Mini-Mental State Examination scores suggest that this results in more severe cognitive side effects. Results, however, might be confounded by the differences in age distribution in the groups.
AB - OBJECTIVES: To compare propofol and thiopental as anesthetic agents for electroconvulsive therapy (ECT) with respect to seizure duration, stimulus charge, clinical effect, and cognitive side effects. METHODS: Randomized, blinded study of 62 depressed patients treated with bilateral ECT. Algorithm-based charge dosing was used. RESULTS: The mean seizure duration of the patients in the thiopental group was 36.3 seconds versus 25.7 seconds in the propofol group (P = 0.001). The charge per treatment was 79.5 mC in the thiopental group versus 109.8 mC in the propofol group (P = 0.026). Sixteen patients in the propofol group (52%) reached the highest electrical dose versus 8 patients (26%) in the thiopental group (P = 0.014). No difference in response to treatment or number of treatments was observed. The mean score on Mini-Mental State Examination (MMSE) was 28.9 in the thiopental group versus 26.8 in the propofol group (P = 0.014). However, age distribution of patients completing the study differed between the groups. CONCLUSIONS: Propofol significantly decreases seizure duration without significant difference in the clinical outcome. Using the employed treatment algorithm, patients anesthetised with propofol received higher electrical charge. Mini-Mental State Examination scores suggest that this results in more severe cognitive side effects. Results, however, might be confounded by the differences in age distribution in the groups.
U2 - 10.1097/YCT.0b013e31818a0203
DO - 10.1097/YCT.0b013e31818a0203
M3 - Journal article
C2 - 19092676
SN - 1095-0680
VL - 25
SP - 85
EP - 90
JO - Journal of Electroconvulsive Therapy
JF - Journal of Electroconvulsive Therapy
IS - 2
ER -