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The standard anesthetic agent for electroconvulsive therapy (ECT) has been methohexital. We compared sevoflurane, a short-acting halogenated anesthetic, to methohexital for induction in ECT. Twelve subjects received sevoflurane or methohexital on alternating treatment days. Seizure duration, time to administering ECT, emergence and recovery, as well as several hemodynamic measures were recorded. A total of 69 treatments were analyzed. When sevoflurane was used, seizure durations recorded by observation and by EEG, were shorter by 10 and 23 seconds, respectively. With sevoflurane, seizure duration remained, however, within a clinically acceptable range. Methohexital allowed faster administration of ECT and discharge from the recovery room (3.8 vs. 6.2 minutes and 40.8 vs. 47.0 minutes, respectively). No difference in the post-ECT hemodynamic changes was found between the two treatments. We conclude that, when indicated, sevoflurane could provide a suitable alternative treatment option to methohexital, but some limitations, including shortened seizure duration and potential side effects, should be kept in mind.

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The neuromuscular and cardiovascular effects of mivacurium chloride were studied during nitrous oxide-oxygen narcotic 6fentanyl) (n = 90) and nitrous oxide-oxygen isoflurane (ISO) anaesthesia (n = 45). In addition, a separate group (n =9Recent development of new muscle relaxants, atracurium, vecuronium, and doxacurium, has met most of the goals outlined by Savarese and Kitz t for the ideal muscle relaxant with an intermediate or long duration of action, but the search continues for a drug with rapid onset and short duration of action. This nondepolarizing drug should be noncumulative and should have a rapid, spontaneous recovery. Succinylcholine is frequently used when rapid onset and short duration of neuromuscular blockade are desired. Its usefulness is limited by a number of side effects mainly related to its depolarizing nature of action. 2-4 Most of these, with the exception of muscle pains, are infrequent but potentially serious.Mivacurium is a new non-depolarizing neuromuscular blocking agent that is rapidly hydrolyzed by plasma cholinesterase and is currently under clinical evaluation as a short-acting neuromuscular blocking agent. Previous CAN I ANAESTH 1989 / 36:6 I pp641-50

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