Effects of propofol anesthesia on cognitive recovery of patients undergoing electroconvulsive therapy

Abstract

The effects of different doses of propofol on post-electroconvulsive therapy (ECT) cognitive recovery were evaluated together with the effects on seizure duration and hemodynamic changes during ECT in 15 depressive patients. Propofol attenuated the increase in arterial blood pressure and heart rate in a dose-dependent manner compared with thiamylal. Propofol showed a clinically significant anticonvulsant effect during ECT in a dose-dependent manner. There were no significant differences among the four different induction groups in the mean recovery time from anesthesia, however, a low dose of propofol suppressed the early recovery of cognitive function. For early cognitive recovery after ECT, a deep anesthetic level is necessary when the traditional ECT apparatus is used which produces sine curve wave stimuli.

Predictors of Seizure Threshold in Right Unilateral Ultrabrief Electroconvulsive Therapy: Role of Concomitant Medications and Anaesthesia Used

“…[23,59]), that appear to be dose-dependent [60,61]. The results of the present study showed clear evidence for higher ST with propofol than thiopentone.…”

“…Generally, anaesthetic doses recommended for ECT are lower than in other interventions, as the anticonvulsant effects have shown to be dose-dependent both in animal [63,64] and human studies [60,61]. However, doses of anaesthesia given for ECT can vary widely [5,23] and even could vary over the ECT course from ECT session to ECT session, depending on the practice of the individual anaesthetist [65].…”

Comparison of Thiopentone Sodium and Propofol as Induction Agents in Modified Electroconvulsive Therapy in Haemodynamic Status and Seizure Duration- A Prospective Double-Blind Randomised Controlled Trial

“…But reports by Sakamoto (1999) (8) shows a reduction in seizure duration associated with increasing doses of thiopentone, i.e. 2 mg/kg which gives a longer seizure duration than 4 mg/kg.…”

“…Regarding the dose of propofol, various dosage regimens were put forward for induction. Noam (2004), (6) Atsushira Sakamoto (8) (1999) Fumio Nishihara (9) (2002) gave dosages of 1 mg/kg, 1.5 mg/kg, 2 mg/kg respectively. Kadoi (10) took propofol 1 mg/kg and succinylcholine for haemodynamic responses in ECT by echocardiography shows significant differences compared to the pre-induction levels (p < 0.05).…”

Cognitive Impairment Following Electroconvulsive Therapy-Does the Choice of Anesthetic Agent Make a Difference?

“…In some studies, 16,18 ECT was given at a set electrical dose, which did not take into account the effects of different anesthetic agents on seizure threshold; that is, the patients may have received different doses relative to seizure threshold with the different anesthetic agents. This is important because it has been suggested that cognitive outcomes post-ECT may be correlated with the degree to which electrical dosage is suprathreshold, rather than the absolute electrical dose.…”