Propofol and Methohexital as Anesthetic Agents for Electroconvulsive Therapy

Geretsegger, Christian; Nickel, Marius; Judendorfer, B.; Rochowanski, Erika; Novak, Erich; Aichhorn, Wolfgang

doi:10.1097/0b013e31814da971

Cited by 62 publications

(13 citation statements)

References 21 publications

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“…Study quality was assessed using the Cochrane Collaboration’s Tool for Assessing Risk of Bias 17 concomitantly to eligibility. We identified 71 studies, 14 of which met inclusion criteria for the present investigation 9 10 11 12 25 26 27 28 29 30 31 32 33 34 .…”

Section: Resultsmentioning

confidence: 99%

“…We identified 3 studies comparing the effect of MET administration (n = 86) to PROP (n = 78) on seizure duration 29 32 33 . MET was found to be significantly associated with higher seizure duration compared to PROP (SMD = 1.690, 95% CI 0.286; 3.094, p = 0.018, I2 = 93.150%).…”

Section: Resultsmentioning

confidence: 99%

“…S-KET 0.4 mg/kg, an enantiomer of KET, associated with PROP, was found to be associated with one serious adverse events (hypertension+agitation) and with increased restlessness and disorientation 9 . Two studies suggested that THIO and METH were respectively associated with higher blood pressure increase compared to PROP 29 31 . In one study, both METH and PROP were associated with one delirious reaction 33 .…”

Section: Resultsmentioning

confidence: 99%

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A Bayesian framework systematic review and meta-analysis of anesthetic agents effectiveness/tolerability profile in electroconvulsive therapy for major depression

Fond

Bennabi

Haffen

et al. 2016

Sci Rep

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The aim of this study was to assess the efficacy and tolerability/acceptability of 6 anesthetic agents in ECT for depressive disorders. We systematically reviewed 14 double-blind randomized controlled trials (610 participants). Efficacy was measured by the mean scores on validated depression scales at 6 ECT (or the nearest score if not available), number of responders at the end of treatment and seizure duration. The acceptability was measured by the proportion of patients who dropped out of the allocated treatment, and the tolerability by the number of serious adverse events and post-treatment cognition assessment. After excluding the trials responsible for heterogeneity, depression scores of patients who were administered methohexital were found to be significantly more improved than those who received propofol (p = 0.001). On the contrary, those who were administered propofol had lower depression scores than those with thiopental at the end of treatment (p = 0.002). Compared to propofol, methohexital was found to be significantly associated with higher seizure duration (p = 0.018). No difference was found for the acceptability profile (all p > 0.05). In summary, ketamine and methohexital may be preferred to propofol or thiopental in regard of effectiveness in depression scores and increased seizure duration. Further studies are warranted to compare ketamine and methohexital.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A Bayesian framework systematic review and meta-analysis of anesthetic agents effectiveness/tolerability profile in electroconvulsive therapy for major depression

Fond

Bennabi

Haffen

et al. 2016

Sci Rep

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“…When combined with other general anesthetics used in ECT (including methohexital and thiopental), propofol did not damage cognitive function and was even found to provide benefit in this regard compared with the effects of the other anesthetics used alone. 7 , 25 In our previous studies, it was shown that propofol itself had a definite antiamnesic effect when used as the sole anesthetic in ECS. 9 , 14 , 26 In the present study, we further showed that propofol combined with MECS (in group M) could reverse memory impairment to a significantly higher level than was observed in the other two depressed groups without undergoing ECS treatments (groups D and P).…”

Section: Discussionmentioning

confidence: 99%

Propofol prevents electroconvulsive-shock-induced memory impairment through regulation of hippocampal synaptic plasticity in a rat model of depression

Luo

Min

Wei

et al. 2014

NDT

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BackgroundAlthough a rapid and efficient psychiatric treatment, electroconvulsive therapy (ECT) induces memory impairment. Modified ECT requires anesthesia for safety purposes. Although traditionally found to exert amnesic effects in general anesthesia, which is an inherent part of modified ECT, some anesthetics have been found to protect against ECT-induced cognitive impairment. However, the mechanisms remain unclear. We investigated the effects of propofol (2,6-diisopropylphenol) on memory in depressed rats undergoing electroconvulsive shock (ECS), the analog of ECT in animals, under anesthesia as well as its mechanisms.MethodsChronic unpredictable mild stresses were adopted to reproduce depression in a rodent model. Rats underwent ECS (or sham ECS) with anesthesia with propofol or normal saline. Behavior was assessed in sucrose preference, open field and Morris water maze tests. Hippocampal long-term potentiation (LTP) was measured using electrophysiological techniques. PSD-95, CREB, and p-CREB protein expression was assayed with Western blotting.ResultsDepression induced memory damage, and downregulated LTP, PSD-95, CREB, and p-CREB; these effects were exacerbated in depressed rats by ECS; propofol did not reverse the depression-induced changes, but when administered in modified ECS, propofol improved memory and reversed the downregulation of LTP and the proteins.ConclusionThese findings suggest that propofol prevents ECS-induced memory impairment, and modified ECS under anesthesia with propofol improves memory in depressed rats, possibly by reversing the excessive changes in hippocampal synaptic plasticity. These observations provide a novel insight into potential targets for optimizing the clinical use of ECT for psychiatric disorders.

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“…[5] Several anesthetic agents such as methohexital, etomidate, ketamine, enflurane, thiopental and propofol are used for this purpose, but the ideal anesthetic agent for ECT procedures remains unclear. [235678] Propofol is widely used in ECT anesthesia as a reference agent due to characteristics such as rapid onset and emergence from anesthesia, minimal postoperative confusion and a lower incidence of hypertension or tachycardia during induction of anesthesia. However, it produces a dose-dependent decrease in seizure duration.…”

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confidence: 99%

Is ketamine-propofol mixture (ketofol) an appropriate alternative induction agent for electroconvulsive therapy?

Firouzian

Tabassomi

2013

Saudi J Anaesth

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Propofol and Methohexital as Anesthetic Agents for Electroconvulsive Therapy

Cited by 62 publications

References 21 publications

A Bayesian framework systematic review and meta-analysis of anesthetic agents effectiveness/tolerability profile in electroconvulsive therapy for major depression

A Bayesian framework systematic review and meta-analysis of anesthetic agents effectiveness/tolerability profile in electroconvulsive therapy for major depression

Propofol prevents electroconvulsive-shock-induced memory impairment through regulation of hippocampal synaptic plasticity in a rat model of depression

Is ketamine-propofol mixture (ketofol) an appropriate alternative induction agent for electroconvulsive therapy?

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