Comparison of Sodium Thiopentone and Propofol for Electroconvusive Therapy(ECT)

Abstract

Background: Seizure activity produced by Electroconvulsive Therapy(ECT) is considered as the therapeutic aspect of this form of treatment, but is accompanied by untoward physiologic consequences, mainly cardiovascular neurological in  nature. The hemodynamic effects can have a significant impact in patients with underlying cardiovascular disease. A number of medications have been used during ECT including pretreatment sedation, anaesthetic agents, muscle relaxants, anticholinergics, and drugs to attenuate parasympathetic and sympathetic responses.  AIMS  AND OBJECTIVES:  This study was carried out to compare propofol and sodium thiopentonne effectswhen used for modified electroconvulsive therapy . METHODOLOGY:  After ethical approval forty patients being planned for modified electroconvulsive therapy were recruited.They were randomly allocated into sodium  thiopentone and propofol groups .The two groups  had propofol 2mg/kg or  sodium thiopentone 5mg/kg respectively and then suxamethonium 1mg/kg. After fasciculation a brief pulse impulse was deliveredby psychiatrist while patient is being ventilated manually with 100% Oxygen.The duration ofseizure,, the time to loss of conscioussness, incidence of complications were recorded.  RESULTS:  This single blinded study was carried out on 40 adult patients equally divided into two groups of 20 each to compare the haemodynamic effects and seizure activity of thiopentone sodium (GroupS) and propofol(Group P) when used as inducing agents in patients undergoing modified electroconvulsive therapy (MECT). Results showed propofol maintained significantly better haemodynamics compared to thiopentone and seizure time was significantly lower with propofol compared to thiopentone . Recovery from anaesthesia post MECT was significantly quicker with propofol compared with thiopentone. Hence,we conclude that  propofol has advantage over thiopentone when used as an induction agent for modified electroconvulsive theraphy.

Keywords: Protocol, Sodium thiopentone, Electroconvulsive therapy.

DOI: 10.7176/JBAH/11-16-02

Publication date:August 31^st 2021