PMID: 11925517Apr 2, 2002Paper

A switch from propofol to etomidate during an ECT course increases EEG and motor seizure duration

The Journal of ECT
Cornelis StadtlandNikolaus Michael

Abstract

Of 58 patients treated at our electroconvulsive therapy (ECT) unit early in the year 2000, 12 patients under propofol did not achieve a seizure duration of >30 s [electroencephalogram (EEG)] with a maximum stimulation charge of 504.0 mC (100%). A switch from propofol to etomidate was therefore undertaken in these patients at the next treatment to achieve longer seizure duration. In 11 of the 12 patients, a remarkable increase in seizure duration was recorded after the change of anesthetic. The mean seizure duration increased from 18.6 to 43.4 s and remained at that level for the following ECT session. The increase was highly significant (t11 = 3.772, p < 0.001). The mean motor seizure also changed from 11.6 to 27.5 s (t11 = 5.560, p < 0.003) and remained there for the next treatment. Our data show that the switch more than doubles EEG seizure duration and suggest that etomidate can be used instead of methohexital as an alternative in patients with short seizure duration. It is also a potential option to avoid the pain frequently associated with the injection of propofol.

References

Oct 1, 1994·The British Journal of Psychiatry : the Journal of Mental Science·C F FearP McQuail
Mar 1, 1993·General Hospital Psychiatry·P T TrzepaczJ Greenhouse
Feb 25, 2000·Psychiatry and Clinical Neurosciences·A SakamotoR Ogawa
Jun 27, 2000·The Journal of ECT·J W FolkT A Duc

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Citations

Dec 14, 2004·The Journal of ECT·Gábor GazdagZsolt Iványi
Aug 30, 2005·The Journal of ECT·Arun SharmaSubhash C Bhatia
Sep 7, 2007·The Journal of ECT·Benjamin T Griffeth, Abhishek Mehra
Jun 19, 2013·Progress in Neuro-psychopharmacology & Biological Psychiatry·Pieternella E GravelandTom K Birkenhäger
Jan 10, 2014·Journal of Evaluation in Clinical Practice·Gillian Ray-BarruelClaire M Rickard
Nov 25, 2004·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Okan CaliyurtErcan Abay

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