Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1398
11
1
gregorian
2020
2
1
34
1
online
1
fulltext
en
The effect of ketamine versus thiopental sodium on hemodynamic profile and seizure duration during electroconvulsive therapy in patients with major depressive disorder: A randomized cross-over clinical trial
Anesthesia
Anesthesia
Original Research
Original Research
<strong>Background: </strong>Electroconvulsive therapy (ECT) is an effective treatment in major depressive disorder (MDD). Earlier studies suggest that ketamine has antidepressive effects and prolongs seizure duration in favor of therapeutic efficacy of ECT. A great concern with the use of ketamine is its possible adverse hemodynamic effects during ECT. This study was conducted to compare the hemodynamic effect and seizure duration between ketamine and sodium thiopental, a common anesthetic in ECT.<br>
<strong>Methods: </strong>In a cross-over clinical trial, 26 patients of either sex with MDD who were candidates for ECT therapy in a university hospital were enrolled. A total of 13 patients received induction with ketamine in the first session and thiopental for the second. The sequence of treatments was vice versa in the other group. The followings were measured in all patients: blood pressure, heart rate, and oxygen saturation before induction, immediately after induction, at 1, 2, 4, and 10 minutes postinduction, and after recovery from anesthesia. Also, seizure duration, recovery time, and complications of treatments were measured. Chi square test and student t test were used for categorical data and numerical data, respectively. P values < 0.05 were considered statistically significant. Analyses were performed with SPSS software version 21.0.<br>
<strong>Results:</strong> Heart rate, systolic and diastolic blood pressure, oxygen saturation, and recovery time were comparable between groups. Mean duration of convulsion in patients who received ketamine was significantly more than those who received STP (36±11 vs 28±9 s, p=0.001). Myalgia was less common in patients who received ketamine rather than sodium thiopental (11.5 vs 46.2%, p=0.014).<br>
<strong>Conclusion:</strong> Ketamine prolongs seizure duration with no deleterious effects on hemodynamic parameters. Considering the antidepressant effects of ketamine, it may be a better choice, compared to thiopental sodium, for MDD patients.
Major depressive disorder, Electroconvulsive therapy, Ketamine, Thiopental Sodium, Anesthesia, Hemodynamic
74
77
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1971-1&slc_lang=en&sid=1
Alireza
Pournajafian
alipn78@yahoo.com
200319475328460063759
200319475328460063759
No
Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran
Hamid Reza
Faiz
hrfaiz@hotmail.com
200319475328460063760
200319475328460063760
No
Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran
Mohammad Ali
Motazedi Ghajar
ghajar_ali@yahoo.com
200319475328460063761
200319475328460063761
No
Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran
Zahra Sadat
Koleini
mariam.koleini1@gmail.com
200319475328460063762
200319475328460063762
No
Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran
Masood
Mohseni
Masood.mohseni@gmail.com
200319475328460063763
200319475328460063763
Yes
Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran