Comparative Effects of Thiopentone and Propofol on Seizure Duration and Recovery Following Modified Electroconvulsive Therapy in Nigerians

摘要

The clinical efficacy of Electroconvulsive Therapy (ECT) depends on the induction of generalized cerebral seizure activity. One goal of anaesthesia for ECT is to relax the voluntary muscles with the aim of reducing convulsive activity and thereby minimize the risk of physical harm to the patient. An anaesthetic induction agent with rapid recovery profile will therefore be most suitable for modified ECT. The aim of the study was to compare the seizure duration and recovery profile of thiopentone and propofol following modified electroconvulsive therapy. In a prospective, randomized, double-blind study, sixty consecutive patients scheduled for ECT were randomly allocated into the unmodified, thiopentone and propofol groups with twenty in each group. Anaesthesia was induced with 1 mg kg-1 of Propofol (PG) and 5 mg kg-1 of Thiopentone (TG) and intravenous suxamethonium chloride was administered at a dose of 0.5 mg kg-1. Anaesthesia was not administered to the patients in the Unmodified Group (UG) which served as control. The patients? heart rate, blood pressure and arterial oxygen saturation were monitored during the procedure. The duration of seizure and the time taken to gain full recovery in the groups were also compared. The shortest mean seizure duration was recorded in PG (23.30±3.06 sec) compared with 34.20±4.35 sec in UG and 28.25±3.58 sec in TG. The duration was significantly less in PG than TG (p = 0.008). The mean time to eye opening and obeying command was significantly less in PG than TG (p = 0.009 and 0.006, respectively) but time to full orientation was not significantly different (p = 0.080). Propofol produced a significant reduction in seizure duration but it is not better than thiopentone with regards to recovery characteristics after ECT.