Comparison of cardiovascular effects of propofol versus sodium thiopental anesthesia in children undergoing electroconvulsive therapy (ECT)

Abstract

Background: Seizures caused by electrical stimulation during electroconvulsive therapy (ECT) should be managed; otherwise, electroconvulsive therapy can be an unpleasant experience. Therefore, sedative short-acting drugs like sodium thiopental, propofol, methohexital, etc. can be used with different hemodynamic changes and adverse effects. Some studies showed that propofol was associated with less complication and hemodynamic changes. The aim of this study was to compare cardiovascular effects and complications of propofol and sodium thiopental in pediatric age group treated with electroconvulsive therapy. Methods: This census double-blind clinical trial study was conducted in Alzahra hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Before electroconvulsive therapy, one group received 2 mg/kg sodium thiopental and the other one 1 mg/kg propofol; then, both groups received 0.5 mg/kg succinylcholine and electroconvulsive therapy was done at least 90 second (1.5 minutes) after that. Heart rate, blood pressure and O2 saturation were measured at 1, 5 and 10 minutes after the seizure. Duration of seizure, language response, return to full consciousness, spontaneous breathing after seizure, and recovery time were measured and also drug adverse effect were assessed as well. Findings: This study was conducted on 70 children aged 6-18 years treated with electroconvulsive therapy. Seizure induction time (P < 0.001), language response time after seizure (P < 0.001) and return to full consciousness (P < 0.001) were significantly shorter in patients received propofol. Headache (P = 0.001), nausea (P = 0.020) and myalgia (P < 0.001) were observed more commonly in group received propofol. Conclusion: According to this study, verbal response time and return to full consciousness following seizure caused by propofol were achieved faster; but the drug caused more adverse effects. © 2017, Isfahan University of Medical Sciences(IUMS). All Rights Reserved.