Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparison of Cardiovascular Effects of Propofol versus Sodium Thiopental Anesthesia in Children Undergoing Electroconvulsive Therapy (ECT)

Document Type : Original Article (s)

Authors
Behzad Nazemoroaya 1
Sayedvahidُ Sayedmoalemi 2
Sayed Ali Emami 2
1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Seizures caused by electrical stimulation during electroconvulsive therapy (ECT) should be managed; otherwise, electroconvulsive therapy can be an unpleasant experience. Therefore, sedative short-acting drugs like sodium thiopental, propofol, methohexital, etc. can be used with different hemodynamic changes and adverse effects. Some studies showed that propofol was associated with less complication and hemodynamic changes. The aim of this study was to compare cardiovascular effects and complications of propofol and sodium thiopental in pediatric age group treated with electroconvulsive therapy.Methods: This census double-blind clinical trial study was conducted in Alzahra hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Before electroconvulsive therapy, one group received 2 mg/kg sodium thiopental and the other one 1 mg/kg propofol; then, both groups received 0.5 mg/kg succinylcholine and electroconvulsive therapy was done at least 90 second (1.5 minutes) after that. Heart rate, blood pressure and O2 saturation were measured at 1, 5 and 10 minutes after the seizure. Duration of seizure, language response, return to full consciousness, spontaneous breathing after seizure, and recovery time were measured and also drug adverse effect were assessed as well.Findings: This study was conducted on 70 children aged 6-18 years treated with electroconvulsive therapy. Seizure induction time (P < 0.001), language response time after seizure (P < 0.001) and return to full consciousness (P < 0.001) were significantly shorter in patients received propofol. Headache (P = 0.001), nausea (P = 0.020) and myalgia (P < 0.001) were observed more commonly in group received propofol.Conclusion: According to this study, verbal response time and return to full consciousness following seizure caused by propofol were achieved faster; but the drug caused more adverse effects.
Keywords
Electroconvulsive Therapy
Propofol
Thiopental sodium
  1. Rosa MA, Rosa MO, Belegarde IM, Bueno CR, Fregni F. Recovery after ECT: comparison of propofol, etomidate and thiopental. Rev Bras Psiquiatr 2008; 30(2): 149-51.
  2. Kheirabadi GR, Vafaei M, Attari A. Intravenous ketamine therapy vs. electroconvulsive therapy in depressive cases. J Isfahan Med Sch 2012; 29(163): 1289-97. [In Persian].
  3. Ding Z, White PF. Anesthesia for electroconvulsive therapy. Anesth Analg 2002; 94(5): 1351-64.
  4. Geretsegger C, Nickel M, Judendorfer B, Rochowanski E, Novak E, Aichhorn W. Propofol and methohexital as anesthetic agents for electroconvulsive therapy: a randomized, double-blind comparison of electroconvulsive therapy seizure quality, therapeutic efficacy, and cognitive performance. J ECT 2007; 23(4): 239-43.
  5. Miner JR, Burton JH. Clinical practice advisory: Emergency department procedural sedation with propofol. Ann Emerg Med 2007; 50(2): 182-7, 187.
  6. Kumar A, Sharma DK, Mani R. A comparison of propofol and thiopentone for electroconvulsive therapy. J Anaesthesiol Clin Pharmacol 2012; 28(3): 353-7.
  7. Dew RE, Kimball JN, Rosenquist PB, McCall WV. Seizure length and clinical outcome in electroconvulsive therapy using methohexital or thiopental. J ECT 2005; 21(1): 16-8.
  8. Bauer J, Hageman I, Dam H, Baez A, Bolwig T, Roed J, et al. 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. J ECT 2009; 25(2): 85-90.
  9. Honarmand A, Khazaei M, Safavi-Homami M. Comparing the effects of low doses of propofol, ketamine and combination of propofol-ketamine in prevention of post-extubation coughing and laryngospasm. J Isfahan Med Sch 2014; 32(297): 1299-309. [In Persian].
  10. Fredman B, d'Etienne J, Smith I, Husain MM, White PF. Anesthesia for electroconvulsive therapy: effects of propofol and methohexital on seizure activity and recovery. Anesth Analg 1994; 79(1): 75-9.
  11. Jarineshin H, Kashani S, Fekrat F, Vatankhah M, Golmirzaei J, Alimolaee E, et al. Seizure Duration and Hemodynamic State During Electroconvulsive Therapy: Sodium Thiopental Versus Propofol. Glob J Health Sci 2015; 8(2): 126-31.
  12. Yazici E, Bosgelmez S, Tas HI, Karabulut U, Yazici AB, Yildiz M, et al. Comparing ECT data of two different inpatient clinics: propofol or thiopental? Int J Psychiatry Clin Pract 2013; 17(4): 307-12.
  13. Naghibi K, Moradi Farsani D, Ali Kiaei B, Hirmanpour A. Comparing the effect of intravenous and inhalational anesthtics on hemodynamic changes in deep vitrectomy surgery. J Arak Univ Med Sci 2016; 19(2): 80-8. [In Persian].
  14. Imantalab V, Haghighi M. Effect of hemodynamic propofol and thiopemtal sodium and during electeroconvulsive therapy. J Guilan Univ Med Sci 2006; 15(57): 59-64. [In Persian].
  15. Lihua P, Su M, Ke W, Ziemann-Gimmel P. Different regimens of intravenous sedatives or hypnotics for electroconvulsive therapy (ECT) in adult patients with depression. Cochrane Database Syst Rev 2014; (4): CD009763.
  16. Rasimas JJ, Stevens SR, Rasmussen KG. Seizure length in electroconvulsive therapy as a function of age, sex, and treatment number. J ECT 2007; 23(1): 14-6.
  17. Butterfield NN, Graf P, Macleod BA, Ries CR, Zis AP. Propofol reduces cognitive impairment after electroconvulsive therapy. J ECT 2004; 20(1): 3-9.
  18. Ingram A, Schweitzer I, Ng CH, Saling MM, Savage G. A comparison of propofol and thiopentone use in electroconvulsive therapy: cognitive and efficacy effects. J ECT 2007; 23(3): 158-62.
  19. Akhvan Akbari P, Molavi P, Akhvan Akbari G, Ghodrati MR. Comparing the effects of propofol and sodium thiopental in the induction of anesthesia for electro convulsive therapy (ECT). J Ardabil Univ Med Sci 2009; 9(3): 249-55. [In Persian].
  20. Martinez-Amoros E, Galvez Ortiz V, Porter Moli M, Llorens Capdevila M, Cerrillo Albaiges E, Garcia-Pares G, et al. Propofol and thiopental as anesthetic agents in electroconvulsive therapy: a retrospective study in major depression. Rev Psiquiatr Salud Ment 2014; 7(1): 42-7.
Journal of Isfahan Medical School
Volume 35, Issue 427 - Serial Number 427
March and April 2017
Pages 463-469

  • Receive Date 24 January 2017
  • Accept Date 06 April 2022