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Differences in cognitive side-effects and seizure parameters between thiopental and propofol narcosis in ECT

Published online by Cambridge University Press:  13 August 2021

E. Kavakbasi ,
A. Wieneke  and
B. Baune
E. Kavakbasi*
Affiliation:
Department Of Psychiatry And Psychotherapy, University of Münster, Münster, Germany
A. Wieneke
Affiliation:
Department Of Psychiatry And Psychotherapy, University of Münster, Münster, Germany
B. Baune
Affiliation:
Department Of Psychiatry And Psychotherapy, University of Münster, Münster, Germany Department Of Psychiatry, Melbourne Medical School, Melbourne, Australia The University Of Melbourne, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
*
*Corresponding author.

Abstract

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Introduction

The standard anaesthetic for electroconvulsive therapy (ECT) in our hospital methohexital was no longer available from the beginning of 2019. A change to alternatives became necessary. We initially decided on thiopental and than switched to propofol after the suspicion of increased occurrence of cognitive deficits due to thiopental narcosis was expressed by clinicians.

Objectives

This retrospective study provides a comparison of the two narcotics in terms of side-effects and seizure parameters.

Methods

We performed a retrospective data collection from our clinical database and identified a total of 64 patients (w=60.9 %, m=39.1 %) got either thiopental (n=35) or propofol (n=29) for ECT narcosis.

Results

The mean age at the beginning of the ECT series was 56.0 years (20-82, SD 17.8, median 57.5). The groups did not differ in terms of age distribution. On average the depressive episode lastet for 9.0 months (SD 11.5, median 6.0) with no difference between the two groups. The mean EEG seizure time was significantly shorter in the propofol group (28.1 sec; 95%-CI: 23.8-32.4) than in the thiopental group (38.3 sec.; 95%-CI: 34.3-38.3). The mean EMG seizure activity was also shortler in the propofol group (12.0 sec.; 95%-CI: 8.0-15.0) compared with the thiopental group (21.5 sec.; 95%-CI: 18.3-24.8). The ECT series was interrupted due to cognitive side-effects in 20 cases. The majority of these cases (n=17) concerned the thiopental group, compared to 3 cases in the propofol group.

Conclusions

Propofol narcosis in ECT was assiosiated with worse seizure parameters, whereas thiopental narcosis was associated with increased risk of cognitive side-effects.

Disclosure

No significant relationships.

Keywords

ect narcosisthiopentalElectroconvulsive therapypropofol
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S782 - S783
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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