Abstract
COMPARATIVE STUDY OF SEVOFLURANE AND PROPOFOL IN ELECTROCONVULSIVE THERAPY

Dr. Khatija Dalvani, Dr. Chetna A. Jadeja*, Dr. Khyati Vaghela, Dr. Urmi Dave, Dr. Pratik Doshi and Dr. Vandana Parmar

ABSTRACT

Background: Electroconvulsive therapy (ECT) is commonly used for treatment of depression, mania, affective disorder etc. Sodium thiopentone is commonly used for anaesthetic management of ECT. Recovery profile of propofol is faster compared to thiopentone. Sevoflurane produces rapid and smooth induction and is rapidly eliminated for ease of recovery. Therefore, we compared sevoflurane with propofol with aim to know acceptability and recovery profile of both the agents for ECT. Materials and Methods: A total of 100 patients scheduled for ECT were randomly divided into Propofol (P) group and Sevoflurane (S) group of 50 each. Group-P patients received Inj. Propofol 1mg/kg i.v. and inj.succinyl choline 0.5 mg/kg i.v. Group-S patients received Sevoflurane 8%, followed by Sevoflurane 2% after loss of eye lash reflex and inj. succinyl choline 0.5 mg/kg was administered i.v. Onset of action, seizure duration, recovery profile , hemodynamics and side effects were noted. Results: Hemodynamics were comparable in both the groups. Seizure duration was 39±6.14sec in Group P, compared to 30.32±7.31sec in Group S and difference was statistically highly significant (p <0.0001). Recovery was assessed with time of following verbal command which was 343.42±63.77sec in Group P compared to 367.28±37.30sec in Group S and was statistically significant (p<0.05) , suggesting faster recovery with propofol compared tosevoflurane. Conclusions: Sevoflurane may offer an alternative anaesthetic induction agent for ECT especially when venous access is problematic from dehydration, agitation, disorientation, confusion or patients' intolerance to venepuncture. Both sevoflurane and propofol are acceptable for management of ECT. Propofol induction was associated with better recovery profile.

Keywords: Sevoflurane, propofol, electroconvulsive therapy, recovery, seizure duration.


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