Anesthesia During Electroconvulsive Therapy

Anand, Sandip; Thirthalli, Jagadisha; Gupta, Arun Kumar; Kongasseri, Sreejayan; Tharayil, Biju S.; Keshavan, Venkatesh H; Gangadhar, Bangalore N.

doi:10.1097/yct.0b013e3181c18a51

Cited by 4 publications

(4 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among these, propofol has the highest potential and thiopental/etomidate has the least potential [49,50]. Although, the dose of anesthetic agent is rarely mentioned as a determinant of seizure threshold, a couple of authors stressed the importance of anesthetic dosage in seizure threshold [19,51]. In the study by Boylan et al [16], the obtained multivariate regression model only contained age, sex and methohexital dose, which was the same conclusion as the present study.…”

Section: Discussionmentioning

confidence: 99%

Initial Seizure Threshold in Brief-Pulse Bilateral Electroconvulsive Therapy in Patients with Schizophrenia or Schizoaffective Disorder

Jeong

Youn

Lee

et al. 2019

Psychiatry Investig

View full text Add to dashboard Cite

ObjectiveThe present study aimed to report the initial seizure threshold (IST) of a brief-pulse bilateral electroconvulsive therapy (BP-BL ECT) in Korean patients with schizophrenia/schizoaffective disorder and to identify IST predictors. MethodsAmong 67 patients who received ECT and diagnosed with schizophrenia/schizoaffective disorder based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, we included 56 patients who received 1-millisecond BP-BL ECT after anesthesia with sodium thiopental between March 2012 and June 2018. Demographic and clinical information was gathered from electronic medical records, and a multiple regression analysis was conducted to identify predictors of the IST. ResultsThe mean age of the patients was 36.9±12.0 years and 30 (53.6%) patients were male. The mean and median IST were 105.9±54.5 and 96 millicoulombs (mC), respectively. The IST was predicted by age, gender, and dose (mg/kg) of sodium thiopental. Other physical and clinical variables were not associated with the IST. ConclusionThe present study demonstrated that the IST of 1-ms BP-BL ECT following sodium thiopental anesthesia in Korean patients was comparable to those reported in previous literature. The IST was associated with age, gender, and dose of sodium thiopental.

show abstract

Section: Discussionmentioning

confidence: 99%

Initial Seizure Threshold in Brief-Pulse Bilateral Electroconvulsive Therapy in Patients with Schizophrenia or Schizoaffective Disorder

Jeong

Youn

Lee

et al. 2019

Psychiatry Investig

View full text Add to dashboard Cite

show abstract

“…In this respect, the mechanisms of propofol’s activity resemble to some extent those of carbamazepine, and this effect may result in propofol’s action on seizure duration. However, studies have reported that the reduction in seizure duration depended on the dose of propofol 25,26. In a study comparing ECT parameters and response to ECT in patients anesthetized with methohexitone, propofol, or etomidate, the mean seizure duration was found to be lowest for propofol, but the choice of anesthetic did not seem to influence therapeutic response to ECT 5…”

Section: Discussionmentioning

confidence: 99%

Influence of valproate on the required dose of propofol for anesthesia during electroconvulsive therapy of bipolar affective disorder patients

Sayar¹,

Eryılmaz²,

Şemieoğlu³

et al. 2014

NDT

View full text Add to dashboard Cite

BackgroundPropofol is often used as an anesthetic agent for electroconvulsive therapy (ECT). In recent studies, propofol was shown to possess significant seizure-shortening properties during ECT. “Valproate” is a mood stabilizer used mainly in the treatment of bipolar affective disorder. It is reported that valproate, being an anticonvulsant, raises the seizure threshold, thus decreases the efficacy of ECT treatment.AimThe purpose of our study was to compare the dose of propofol in valproate-using patients and valproate-free patients.MethodsIn an open design, 17 patients with bipolar affective disorder manic episodes who were to be treated with valproate and ECT in combination, were compared with 16 manic-episode patients who were to be treated with ECT but not valproate. The two groups were compared on the basis of electroencephalography-registered seizure duration and the propofol dosage required to induce anesthesia.ResultsValproate, compared with no valproate treatment, results in a decrease in the propofol dose required to induce anesthesia. In the valproate group of study participants, seizure duration was significantly shorter than in the valproate-free group.ConclusionThe results suggest that valproate reduces the dose of propofol required for anesthesia during ECT treatment in patients with bipolar affective disorder manic episodes. Although propofol is a safe and efficacious anesthetic for ECT treatment, lower doses of propofol should be used to induce anesthesia for patients under valproate treatment. When the clinician needs to prolong seizure duration in patients treated with valproate, interruption of the valproate treatment or an anesthetic agent other than propofol should be considered.

show abstract

“…These factors can significantly affect seizure induction in the ECT [24][25]. There is no drug that has all of these conditions said [22].…”

Section: Introductionmentioning

confidence: 99%

“…There is no drug that has all of these conditions said [22]. Therefore, choosing the appropriate anesthetic agent and proper dosage is an essential requirement for shock-induced electrical therapy [24][25]. For many years, Methohexital was the preferred anesthetic agent for ECT [26,27,5], but some restrictions, such as rarely available in some countries, have reduced the use of this drug and increased use of drugs such as propofol and thiopental [5,27].…”

Section: Introductionmentioning

confidence: 99%

The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

Nanaei

Bahrami

Kasani

2019

JPRI

View full text Add to dashboard Cite

Background and Aim: Regarding the controversial results on the effects of anesthetics, especially thiopental sodium, on the duration and severity of seizure and the lack of adequate information on the use of doses of anesthetic and paralysing drugs during ECT, this study was designed to determine the effect of repetitive doses of succinylcholine and Thiopental sodium was administered on the duration and severity of seizure during ECT. Materials and Methods: The present study was a one-blind randomized clinical trial on patients admitted to the psychiatric ward of Dezful Ganjavian Hospital. The research samples were selected after informed consent and entry criteria. Then, the samples were randomly assigned to two groups. In one group, succinylcholine dose was repeated (one third of the initial dose), and in the other group, the dose of thiopental sodium was repeated (one third of the initial dose). In all patients, seizure duration based on EEG monitoring and severity of seizure was determined by the psychiatrist based on the symptoms of the patient during seizure. Results: There was a significant difference between the quality of seizure in the two treatment groups after the intervention. There was a strong and good seizure in the thiopental sodium group (p <0.0001). There was a significant difference between the variables of seizure status in comparison with the previous shock in the two treatment groups after the intervention (p <0.0001). The duration of seizure was higher in thiopental sodium treatment group, but no significant difference was observed (p = 0.82). Conclusion: The results of this study showed that the duration and quality of seizure was better in patients requiring repetitive doses of hypnotic drugs (Thiopental Sodium), which was used to repeat the dose of muscle relaxant (succinylcholine).

show abstract

Anesthesia During Electroconvulsive Therapy

Cited by 4 publications

References 1 publication

Initial Seizure Threshold in Brief-Pulse Bilateral Electroconvulsive Therapy in Patients with Schizophrenia or Schizoaffective Disorder

Initial Seizure Threshold in Brief-Pulse Bilateral Electroconvulsive Therapy in Patients with Schizophrenia or Schizoaffective Disorder

Influence of valproate on the required dose of propofol for anesthesia during electroconvulsive therapy of bipolar affective disorder patients

The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

Contact Info

Product

Resources

About