Yıl: 2021 Cilt: 49 Sayı: 1 Sayfa Aralığı: 44 - 51 Metin Dili: İngilizce DOI: 10.5152/TJAR.2020.157 İndeks Tarihi: 11-10-2021

Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy

Öz:
Objective: This study aimed to evaluate the effects of adding different doses of remifentanil to propofol treatment compared with propofol alone with regard to parameters, including the seizure duration, haemodynamic changes and recovery time, in patients undergoing electroconvulsive therapy (ECT).Methods: This study was designed as a self-controlled, prospective, double-blind investigation of 17 patients between the ages of 20 and 65 years who had planned treatment with ECT at a psychiatric clinic. Group P (propofol) was administered 10 mL of normal saline after 0.5 mg kg-1 intravenous (IV) bolus of propofol. Group R I (propofol plus remifentanil-1) was administered 1.5 μg kg-1 of remifentanil, and group R II (propofol plus remifentanil-2) was given 2 μg kg-1 of remifentanil after 0.5 mg kg-1 IV bolus of propofol. The haemodynamic variables after seizure and the seizure duration were recorded. Time to return to spontaneous respiration, eye opening and achieving Aldrete score >9 were recorded.Results: The electroencephalography seizure duration was significantly longer in groups R I (34.7±13 s) and R II (34.9±12) than in group P (24±7.5). Motor seizure duration was longer in groups R I (29.70±12.8) and R II (28.1±10) than in group P (21±7.3). The amount of total propofol was 121±21 mg in group P, 69.4±2 mg in group R I and 67±17 mg in group R II. Times to eye opening, following simple commands, and achieving Aldrete score >9 were significantly shorter in groups R I and R II than in group P.Conclusion: ECT is a safe and effective treatment for patients with psychiatric disorders. Propofol-remifentanil anaesthesia prolongs the seizure duration and shortens the recovery time, suggesting that this combination may particularly be well suited for use in this patient group.
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  • 1. Soehle M, Bochem J. Anesthesia for electroconvulsive therapy. Curr Opin Anaesthesiol 2018; 31: 501-5. [Crossref]
  • 2. Taylor S. Electroconvulsive therapy: a review of history, patient selection, technique, and medication management. South Med J 2007; 100: 494-8. [Crossref]
  • 3. Vaidya PV, Anderson EL, Bobb A, Pulia K, Jayaram G, Reti I. A within-subject comparison of propofol and methohexitalanesthesia for electroconvulsive therapy. J ECT 2012; 28: 14-9. [Crossref]
  • 4. Fond G, Bennabi D, Haffen E, Brunel L, Micoulaud-Franchi JA, Loundou A, et al. Bayesian framework systematic review and meta-analysis of anesthetic agents effectiveness/tolerability profile in electroconvulsive therapy for major depression. Sci Rep 2016; 6: 19847. [Crossref]
  • 5. Boylan LS, Haskett RF, Mulsant BH, Brunel L, Micoulaud-Franchi JA, Loundou A, et al. Determinants of seizure threshold in ECT: benzodiazepine use, anesthetic dosage, and other factors. J ECT 2000; 16: 3-18. [Crossref]
  • 6. Gálvez V, Hadzi-Pavlovic D, Smith D, Loo CK. Predictors of seizure threshold in right unilateral ultrabrief electroconvulsive therapy: role of concomitant medications and anaesthesia used. Brain Stimul 2015; 8: 486-92. [Crossref]
  • 7. Hoyer C, Kranaster L, Janke C, Sartorius A. Impact of the anesthetic agents ketamine, etomidate, thiopental, and propofol on seizure parameters and seizure quality in electroconvulsive therapy: a retrospective study. Eur Arch Psychiatry Clin Neurosci 2014; 264: 255-61. [Crossref]
  • 8. Hooten WM, Rasmussen KG Jr. Effects of general anesthetic agents in adults receiving electroconvulsive therapy: a systematic review. J ECT 2008; 24: 208-23. [Crossref]
  • 9. Stripp TK, Jorgensen MB, Olsen NV. Anaesthesia for electroconvulsive therapy - new tricks for old drugs: a systematic review. Acta Neuropsychiatr 2018; 30: 61-9. [Crossref]
  • 10. Lowson S, Gent JP, Goodchild CS. Anticonvulsant properties of propofol and thiopentone: comparison using two tests in laboratory mice. Br J Anaesth 1990; 64: 59-63. [Crossref]
  • 11. Ding Z, White PF. Anesthesia for electroconvulsive therapy. Anesth Analg 2002; 94: 1351-64. [Crossref]
  • 12. Fredman B, d’Etienne J, Smith I, Husain MM, White PF. Anesthesia for electroconvulsive therapy: effects of propofol and methohexital on seizure activity and recovery. Anesth Analg 1994; 79: 75-9. [Crossref]
  • 13. Avramov MN, Husain MM, White PF. The comparative effects of methohexital, propofol and etomidate for electroconvulsive therapy. Anesth Analg 1995; 81: 596-602. [Crossref]
  • 14. Chen ST. Remifentanil: a review of its use in electroconvulsive therapy. J ECT 2011; 27: 323-7. [Crossref]
  • 15. Smith DL, Angst MS, Brock-Utne JG, DeBattista C. Seizure duration with remifentanil/methohexital vs. methohexital alone in middle aged patients undergoing electroconvulsive therapy. Acta Anaesthesiol Scand 2003; 47: 1064-6. [Crossref]
  • 16. Sienaert P, Bouckaert F, Hagon A, Hagon B, Peuskens J. Short seizures in continuation electroconvulsive therapy: an indication for remifentanil anesthesia? J ECT 2004; 20: 130-1. [Crossref]
  • 17. Tripathi A, Winek NC, Goel K, D’Agati D, Gallegos J, Jayaram G, et al. Electroconvulsive therapy pre-treatment with low dose propofol: comparison with unmodified treatment. J Psychiatr Res 2014; 53: 173-9. [Crossref]
  • 18. Nishiyama M, Togashi H. Effects of anesthetic agents on seizure duration and hemodynamics in electroconvulsive therapy. Masui 2009; 58: 1266-9.
  • 19. Wojdacz R, Święcicki Ł, Antosik-Wójcińska A. Comparison of the effect of intravenous anesthetics used for anesthesia during electroconvulsive therapy on the hemodynamic safety and the course of ECT. Psychiatr Pol 2017; 51: 1039-58. [Crossref]
  • 20. Lihua P, Su M, Ke W, Ziemann-Gimmel P. Different regimens of intravenous sedatives or hypnotics for electroconvulsive therapy (ECT) in adult patients with depression. Cochrane Database Syst Rev 2014; 4: CD009763
  • 21. Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth 1995; 7: 89-91. [Crossref]
  • 22. Recart A, Rawai S, White PF, Byerly S, Thornton L. The effect of remifentanil on seizure duration and acute hemodynamic responses to electroconvulsive therapy. Anesth Analg 2003; 96: 1047-50. [Crossref]
  • 23. Andersen FA, Arsland D, Holst-Larsen H. Effects of methohexitone-remifentanil anaesthesia in electroconvulsive therapy. Acta Anaesthesiol Scand 2001; 45: 830-3. [Crossref]
  • 24. Akcaboy ZN, Akcaboy EY, Yigitbas B, Bayam G, Dikmen B, Gogus N, et al. Effects of remifentanil and alfentanil on seizure duration, stimulus amplitudes and recovery parameters during ECT. Acta Anaesthesiol Scand 2005; 49: 1068-71. [Crossref]
  • 25. Dinwiddie SH, Glick DB, Goldman MB. The effect of propofol-remifentanil anesthesia on selected seizure quality indices in electroconvulsive therapy. Brain Stimul 2012; 5: 402-7. [Crossref]
  • 26. Zorumski CF, Burke WJ, Rutherford JL, Reich T. ECT: clinical variables, seizure duration, and outcome. Convuls Ther 1986; 2: 109-19.
  • 27. Dew RE, Kimball JN, Rosenquist PB, McCall WV. Seizure length and clinical outcome in electroconvulsive therapy using methohexital or thiopental. J ECT 2005; 21: 16-8. [Crossref]
  • 28. Rabheru K. The use of electroconvulsive therapy in special patient populations. Can J Psychiatry 2001; 46: 710-9. [Crossref]
  • 29. Rasmussen KG. Propofol for ECT anesthesia a review of the literature. J ECT 2014; 30: 210-5. [Crossref]
  • 30. Vishne T, Aronov S, Amiaz R, Etchin A, Grunhaus L. Remifentanil supplementation of propofol during electroconvulsive therapy: effect on seizure duration and cardiovascular stability. J ECT 2005; 21: 235-8. [Crossref]
  • 31. Locala JA, Irefin SA, Malone D, Cywinski JB, Samuel SW, Naugle R. The comparative hemodynamic effects of methohexital and remifentanil in ECT. J ECT 2005; 21: 12-5. [Crossref]
  • 32. Kadoi Y, Saito S. Effects of adding remifentanil to propofol anesthesia on systemic hemodynamics, cardiac output, and middle cerebral artery flow velocity during electroconvulsive therapy: a pilot study. J ECT 2015; 31: 98-100. [Crossref]
APA ikiz c, Günenç S, İyilikçi L, Ozbilgin S, Ellidokuz H, Cimilli H, MERMİ BAL Z, gokel e (2021). Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. , 44 - 51. 10.5152/TJAR.2020.157
Chicago ikiz canan,Günenç Sakize Ferim,İyilikçi Leyla,Ozbilgin Sule,Ellidokuz Hülya,Cimilli Hasan Can,MERMİ BAL ZEHRA,gokel erol Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. (2021): 44 - 51. 10.5152/TJAR.2020.157
MLA ikiz canan,Günenç Sakize Ferim,İyilikçi Leyla,Ozbilgin Sule,Ellidokuz Hülya,Cimilli Hasan Can,MERMİ BAL ZEHRA,gokel erol Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. , 2021, ss.44 - 51. 10.5152/TJAR.2020.157
AMA ikiz c,Günenç S,İyilikçi L,Ozbilgin S,Ellidokuz H,Cimilli H,MERMİ BAL Z,gokel e Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. . 2021; 44 - 51. 10.5152/TJAR.2020.157
Vancouver ikiz c,Günenç S,İyilikçi L,Ozbilgin S,Ellidokuz H,Cimilli H,MERMİ BAL Z,gokel e Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. . 2021; 44 - 51. 10.5152/TJAR.2020.157
IEEE ikiz c,Günenç S,İyilikçi L,Ozbilgin S,Ellidokuz H,Cimilli H,MERMİ BAL Z,gokel e "Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy." , ss.44 - 51, 2021. 10.5152/TJAR.2020.157
ISNAD ikiz, canan vd. "Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy". (2021), 44-51. https://doi.org/10.5152/TJAR.2020.157
APA ikiz c, Günenç S, İyilikçi L, Ozbilgin S, Ellidokuz H, Cimilli H, MERMİ BAL Z, gokel e (2021). Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. Turkish Journal of Anaesthesiology and Reanimation, 49(1), 44 - 51. 10.5152/TJAR.2020.157
Chicago ikiz canan,Günenç Sakize Ferim,İyilikçi Leyla,Ozbilgin Sule,Ellidokuz Hülya,Cimilli Hasan Can,MERMİ BAL ZEHRA,gokel erol Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. Turkish Journal of Anaesthesiology and Reanimation 49, no.1 (2021): 44 - 51. 10.5152/TJAR.2020.157
MLA ikiz canan,Günenç Sakize Ferim,İyilikçi Leyla,Ozbilgin Sule,Ellidokuz Hülya,Cimilli Hasan Can,MERMİ BAL ZEHRA,gokel erol Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. Turkish Journal of Anaesthesiology and Reanimation, vol.49, no.1, 2021, ss.44 - 51. 10.5152/TJAR.2020.157
AMA ikiz c,Günenç S,İyilikçi L,Ozbilgin S,Ellidokuz H,Cimilli H,MERMİ BAL Z,gokel e Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. Turkish Journal of Anaesthesiology and Reanimation. 2021; 49(1): 44 - 51. 10.5152/TJAR.2020.157
Vancouver ikiz c,Günenç S,İyilikçi L,Ozbilgin S,Ellidokuz H,Cimilli H,MERMİ BAL Z,gokel e Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy. Turkish Journal of Anaesthesiology and Reanimation. 2021; 49(1): 44 - 51. 10.5152/TJAR.2020.157
IEEE ikiz c,Günenç S,İyilikçi L,Ozbilgin S,Ellidokuz H,Cimilli H,MERMİ BAL Z,gokel e "Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy." Turkish Journal of Anaesthesiology and Reanimation, 49, ss.44 - 51, 2021. 10.5152/TJAR.2020.157
ISNAD ikiz, canan vd. "Effects of Propofol and Propofol-Remifentanil Combinations on Haemodynamics, Seizure Duration and Recovery during Electroconvulsive Therapy". Turkish Journal of Anaesthesiology and Reanimation 49/1 (2021), 44-51. https://doi.org/10.5152/TJAR.2020.157