مقايسه تاثير پروپوفل و تيوپنتال بكار رفته در الكتروشوك درماني بر تغييرات هموديناميك و طول مدت تشنج در بيماران روانپزشكي

A comparison of effects of Propofol and thiopental used in ECT on homodynamic changes and seizure duration in psychotic patients in 1384

Background and Aim: General anaesthesia is required for the safe conduct of electro convulsive therapy (ECT). The anaesthetic agentʹs have effects on seizure duration, homodynamic changes and recovery time. The purpose of this study was to compare the effects of propofol and thiopental, as anaesthetic agents used for induction of anaesthesia for ECT, on seizure duration, homodynamic changes and recovery time. Materials and Methods: It is a crossover RCT . Twenty ASA 1 and 2 patients who had been referred by the psychiatric service for ECT, divided randomly into two groups. Patients received propofol or thiopental every other day for up to four ECTʹs. Bilateral ECT was performed after the administration of Atropine (0/5mg) Propofol (115mg/kg) or thiopental (3mglkg), succinylcoline (0/5mg/kg) and then assisted mask ventilation with 100% oxygen. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured and recorded automatically before anaesthesia and at 1, 5 and 10 minute after termination of anaesthesia. Seizure duration, time onset for opening the eyes on command, sitting up and walking for 10 meters unaided were also recorded. Data were analyzed by means of SPSS and ANOVA and T test. Results: ECT-induced rises in SBP, DBP and HR were the same for propofol and thiopental. Seizure duration had no difference for the two drugs. Opening the eyes on command (p=0.02), and sitting up (p=0.009) and being able to walk for 10 meters without otherʹs help (p=0.01) were significantly delayed with thiopental. Conclusion: The results of our study indicate that ECT-Induced homodynamic changes and seizure duration are the same for thiopental and propofol. Opening the eyes on command, sitting and ability to walk for 10 meters unaided were delayed with thiopental. In the settings without standard post anaesthesia care unit, propofol is more suitable than thiopental for ECT because of shorter recovery time.