Melekşah Pekel1, Nadide Aysun Postaci2, İsmail Aytaç2, Derya Karasu3, Hüseyin Keleş4, Özlem Şen5, Bayazit Dikmen6, Erol Göka7. 1. Department of Anesthesiology and Reanimation, Private Deniz Hospital, İzmir, Turkey. 2. Department of Anesthesiology and Reanimation, Ankara Numune Education and Research Hospital, Ankara, Turkey. 3. Department of Anesthesiology and Reanimation, Bursa Şevket Yılmaz Education and Research Hospital, Bursa, Turkey. 4. İstanbul Forensic Medicine Institute Sixth Forensic Medicine Council, İstanbul, Turkey. 5. Department of Anesthesiology and Reanimation, Doktor Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey. 6. Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University Ankara, Turkey. 7. Department of Psychiatry, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Abstract
BACKGROUND/AIM: In this prospective randomized cross-over study we compare the effects of sevoflurane versus propofol for electroconvulsive therapy (ECT) anesthesia. MATERIALS AND METHODS: Twenty four patients (ASA I-III, 18-65 years old) receiving ECT three times per week were included. Anesthesia was induced with either propofol (0.75 mg/kg iv) or 5% sevoflurane in 100% oxygen. Consecutive ECT sessions followed a 2 × 2 crossover design and a 2-day washout period until the 10th ECT. Intravenous succinylcholine (1 mg/kg) was administered while bispectral index (BIS) values were ≤60%. RESULTS:Electromyogram and electroencephalogram seizure duration, postictal suppression index, BIS values, mean arterial blood pressure (MAP), heart rate, times to start of spontaneous respiration, eye opening, understanding verbal commands, and side effects were compared. No differences were found between the regimens for seizure activity and recovery. At the end of ECT, MAP was higher with sevoflurane. Although BIS values were higher after sevoflurane, no differences between the regimens were found in terms of the need of muscle relaxants and in hypnosis levels. CONCLUSION:Sevoflurane (5%) may be an effective alternative to propofol for induction of anesthesia for ECT.
RCT Entities:
BACKGROUND/AIM: In this prospective randomized cross-over study we compare the effects of sevoflurane versus propofol for electroconvulsive therapy (ECT) anesthesia. MATERIALS AND METHODS: Twenty four patients (ASA I-III, 18-65 years old) receiving ECT three times per week were included. Anesthesia was induced with either propofol (0.75 mg/kg iv) or 5% sevoflurane in 100% oxygen. Consecutive ECT sessions followed a 2 × 2 crossover design and a 2-day washout period until the 10th ECT. Intravenous succinylcholine (1 mg/kg) was administered while bispectral index (BIS) values were ≤60%. RESULTS: Electromyogram and electroencephalogram seizure duration, postictal suppression index, BIS values, mean arterial blood pressure (MAP), heart rate, times to start of spontaneous respiration, eye opening, understanding verbal commands, and side effects were compared. No differences were found between the regimens for seizure activity and recovery. At the end of ECT, MAP was higher with sevoflurane. Although BIS values were higher after sevoflurane, no differences between the regimens were found in terms of the need of muscle relaxants and in hypnosis levels. CONCLUSION:Sevoflurane (5%) may be an effective alternative to propofol for induction of anesthesia for ECT.