Dexmedetomidine and Nitrous Oxide as Anesthetic Agents for Electroconvulsive Therapy

Abstract

Electroconvulsive therapy (ECT) is a therapeutic intervention that induces generalized seizures under general anesthesia. This case report compares the efficacy of dexmedetomidine (DEX) and nitrous oxide (N2O) to that of propofol during ECT procedures. A 33-year-old woman with a 15-year history of schizophrenia and recurrent psychotic episodes underwent ECT. During a previous hospitalization, she underwent 14 ECT sessions using propofol and succinylcholine. The mean electrical stimulation dose was 598.9 ± 237.6 mC, with mean motor and electroencephalogram seizure durations of 23.8 ± 8.0 and 34.9 ± 8.3 seconds, respectively. During her current hospitalization, she underwent an additional 14 ECT sessions using DEX and N2O. The mean electrical stimulation dose was significantly lower, at 239.4 ± 54.7 mC, with comparable motor and electroencephalogram seizure durations of 34.6 ± 11.6 and 36.3 ± 12.5 seconds, respectively. Our case report emphasizes the effectiveness of using DEX and N2O for ECT anesthesia compared to propofol. Despite a significantly lower mean electrical stimulation dose requirement with DEX and N2O (t = 5.5155, P < 0.00001), no significant differences were observed in electroencephalogram seizure duration between the groups.