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Comparative Study of Propofol Versus Thiopentone Using Glycopyrrolate as Anticholinergic Drug and Succinylcholine as Muscle Relaxant in Modified Electroconvulsive Therapy

Himanshu A. Shah, Professor, Department of Anaesthesiology & Consultant Cardiac Anaesthetist, Parul Institute of Medical Science & Research, Waghodia, Vadodara, Gujarat 391760, India. , Himanshu A. Shah1 , Jaimin Pandya2 , Amit Chauhan3

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Indian Journal of Anesthesia and Analgesia 5(11):p 1947-1951, November-December 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.26

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Abstract

  Introduction : Electroconvulsive Therapy (ECT) induces seizure to treat depression and other psychiatric disorders .To prevent musculoskeletal injuries and to produce amnesia, anaesthesia is needed during ECT. Aim: To compare propofol and thiopentone in patients posted for modified ECT. Materials and Methods: Study was conducted on ASA Grade I and II patients (total 100) posted for ECT. They were randomly divided equally in Propofol Group (Group P) and Thiopentone Group (Group T) (n=50 for each group). Each patient underwent series of bilateral ECT. In both the groups, Inj. Oandansetron 4 mg and Inj. Glycopyrrolate 0.2 mg were given intravenously (iv) 3 minutes before giving the drug under study. Inj.Thiopentone (2.5%)was given in the dose of 2 mg/ kg iv in Group T and Inj. Propofol (1%) was given in the dose of 1 mg/kg iv in Group P, followed by Inj Succinlyscoline 0.5 mg/ kg iv in both the Groups. Onset of action(induction time), mean stimulus charge, duration of seizure, number of missed seizures, vital parameters (hemodynamic parameters), duration of recovery from anaesthesia (response to verbal command), complications were compared. All patients were evaluated by the psychiatrist on the BDI (Beck Depression Inventory) scale after completion of the treatment. Results: Mean seizure duration was shorter in Group P than Group T (44.18±1.24 seconds versus 55.52±1.05 seconds). Mean stimuls charge was 149.50±1.25 mC (Millicoulomb) in Group P and 136.22±0.96 mC in Group T. Number of ECTs required to attain therapeutic goal was higher in Group P than Group T (8.16±0.24 versus 6.46±0.21). Propofol was associated with lower increase in blood pressure. Induction time and Recovery were faster in Group P than Group T. There was
no difference in treatment outcome. Conclusion: Propofol decreases seizure duration even with higher stimulus charge. Propofol increases number of ECT required for treatment. Induction time and recovery both were faster with propofol. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.26

Keywords

ECT; Propofol; Seizures; Thiopentone; Hemodynamic Parameters.

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