Comparison of Propofol and Thiopentone as anaesthetic agents for electroconvulsive therapy - A prospective, double blinded cross over trial
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 5, Issue 1
Abstract
Background: The ideal anaesthetic agent for electroconvulsive therapy (ECT) should provide a smooth, rapid induction and recovery with minimal antagonistic effect on the seizure activity. We compared two induction agents- Propofol and Thiopentone for their effects on hemodynamic response, seizure duration and recovery characteristics during ECT. Method: We conducted a double blinded randomized repeated measure cross over trial in 50 patients planned for ECT under General Anaesthesia. Each patient received four sittings of ECT and the induction agent was alternated in each sitting. The main aim was to compare the duration of seizure activity, recovery time, hemodynamic parameters measured prior to induction and at various intervals after the conclusion of ECT among the two group: Group P (Propofol) and Group T (Thiopentone). Results: Maximal increase in Heart rate for both the groups, Group T(111.01/min ±17.62) and Group P (99.41/min ±16.97) was in the third minute with a higher increase in Group T. Peak Systolic blood pressure for both the groups was seen at the 3 mins, with a significant increase in Group T(165.79 mmHg ±23.87) than Group P(139.57 mmHg ± 16.28). Group T had a higher diastolic blood pressure (102.42 mmHg ±20.24) in the first minute when compared to Group P ( 88.18mmHg ±15.52) which also exhibited maximal increase in the diastolic blood pressure in the first minute. The seizure duration was shorter in Group P (19.65seconds ± 8.46) than Group T (27.98 seconds ± 10.97) seconds. Patients of Group T had a longer recovery time (10.39min±5.74) than Group P (7min±1.87). Conclusion: Propofol has better hemodynamic response with early recovery than Thiopentone and can be safely concluded as an ideal anaesthetic agent for ECT despite its effect on the seizure duration.
Authors and Affiliations
Anand B, Nimi G, Selvakumaran .
A prospective randomised comparative study of efficacy of combination of inj. exmedetomidine–propofol and inj.fentanyl-propofol for the insertion conditions of proseal laryngeal mask airway
Background: Dexmedetomidine over a period of time has been studied with Propofol as a co-induction agent to assess the haemodynamic response, Propofol dose requirement and overall insertion condition of laryngeal mask ai...
A prospective randomized clinical trial for comparison of tramadol and dexmedetomidine for the control of intraoperative shivering under spinal anaesthesia
Background and Aims: Pharmacological methods using variety of drugs like pethidine, morpine, tramadol, clonidine, doxapram, ketansarine, neofam, neostigmine, magnesium sulfate have been tried in post spinal shivering. In...
A Study effectiveness of hemodynamic responses to laryngoscopy and endotracheal intubation to intravenous dexmedetomidine with respect to different doses
Background: The process of intubation is a noxious stimuli leading to a period of extreme haemodynamic stress and is accompanied with intense sympathetic activity marked by tachycardia and hypertension. Aims and Objectiv...
Anaesthetic management of a case of dilated cardiomyopathy for breast surgery with supraglottic airway device
Background: Dilated cardiomyopathy (DCM) is defined as a myocardial disease characterised by left ventricle (LV) or biventricular dilatation, normal LV wall thickness, and systolic dysfunction. DCM is defined by two key...
A prospective randomised study to compare serum lactate level in patients receiving induced controlled hypotension with propofol and isoflurane for functional endoscopic sinus surgery
Lactate which the metabolic end product of anaerobic metabolism is being used as a marker of hypoperfusion. It is seen is various conditions which decrease tissue perfusion and hence used as a marker for inadequate cellu...