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Comparison of propofol and etomidate regarding impact on seizure threshold during electroconvulsive therapy in patients with schizophrenia.
Neuropsychopharmacol Hung. 2007 Oct; 9(3):125-30.NH

Abstract

BACKGROUND

While propofol is known to shorten seizures during electroconvulsive therapy, in our previous study on patients with schizophrenia, there was no need for more frequent restimulations when using propofol compared with etomidate. We hypothesized that etomidate and propofol have similar effects on seizure activity in cases where seizure duration is shorter than 20 seconds. In this study, etomidate and propofol are compared regarding their impact on seizure threshold and seizure duration.

METHOD

30 schizophrenic patients participated in this prospective randomized cross-over study. For anesthetic induction were 1 mg/kg of propofol or 0.2 mg/kg of etomidate used alternately. For both anesthetics, seizure threshold was determined by titrating the dose of the stimulus necessary for eliciting a seizure. Seizure durations were also compared.

RESULTS

After etomidate induction, seizure durations registered either by EEG or by EMG were longer than propofol treated cases (EEG: 49.6+/-23.1 s, versus 39.7+/-19 s, p=0.026; EMG: 41.4+/-22 s, versus 32.8+/-17.6 s, p=0.016). However, no significant differences were found for minimum seizure eliciting stimulation energy or the number of restimulations between the two anesthetics (41.58 mC+/-13.6 mC, versus 41.58 mC+/-11.1 mC, p=1.00).

CONCLUSION

During the ECT of patients with schizophrenia, propofol was shown to possess significant seizure-shortening properties, but it does not elevate seizure threshold or drop seizure duration under the minimal threshold more frequently than etomidate does. Based on these findings, we conclude that the use of propofol does not result in a greater electric load on the patients than etomidate.

Authors+Show Affiliations

Szent László Kórház, Addiktológiai és Pszichiátriai Ambulancia, Budapest, Hungary. gazdag@lamb.huNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18399030

Citation

Gábor, Gazdag, et al. "Comparison of Propofol and Etomidate Regarding Impact On Seizure Threshold During Electroconvulsive Therapy in Patients With Schizophrenia." Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet Lapja = Official Journal of the Hungarian Association of Psychopharmacology, vol. 9, no. 3, 2007, pp. 125-30.
Gábor G, Judit T, Zsolt I. Comparison of propofol and etomidate regarding impact on seizure threshold during electroconvulsive therapy in patients with schizophrenia. Neuropsychopharmacol Hung. 2007;9(3):125-30.
Gábor, G., Judit, T., & Zsolt, I. (2007). Comparison of propofol and etomidate regarding impact on seizure threshold during electroconvulsive therapy in patients with schizophrenia. Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet Lapja = Official Journal of the Hungarian Association of Psychopharmacology, 9(3), 125-30.
Gábor G, Judit T, Zsolt I. Comparison of Propofol and Etomidate Regarding Impact On Seizure Threshold During Electroconvulsive Therapy in Patients With Schizophrenia. Neuropsychopharmacol Hung. 2007;9(3):125-30. PubMed PMID: 18399030.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of propofol and etomidate regarding impact on seizure threshold during electroconvulsive therapy in patients with schizophrenia. AU - Gábor,Gazdag, AU - Judit,Tolna, AU - Zsolt,Iványi, PY - 2008/4/11/pubmed PY - 2008/5/17/medline PY - 2008/4/11/entrez SP - 125 EP - 30 JF - Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet lapja = official journal of the Hungarian Association of Psychopharmacology JO - Neuropsychopharmacol Hung VL - 9 IS - 3 N2 - BACKGROUND: While propofol is known to shorten seizures during electroconvulsive therapy, in our previous study on patients with schizophrenia, there was no need for more frequent restimulations when using propofol compared with etomidate. We hypothesized that etomidate and propofol have similar effects on seizure activity in cases where seizure duration is shorter than 20 seconds. In this study, etomidate and propofol are compared regarding their impact on seizure threshold and seizure duration. METHOD: 30 schizophrenic patients participated in this prospective randomized cross-over study. For anesthetic induction were 1 mg/kg of propofol or 0.2 mg/kg of etomidate used alternately. For both anesthetics, seizure threshold was determined by titrating the dose of the stimulus necessary for eliciting a seizure. Seizure durations were also compared. RESULTS: After etomidate induction, seizure durations registered either by EEG or by EMG were longer than propofol treated cases (EEG: 49.6+/-23.1 s, versus 39.7+/-19 s, p=0.026; EMG: 41.4+/-22 s, versus 32.8+/-17.6 s, p=0.016). However, no significant differences were found for minimum seizure eliciting stimulation energy or the number of restimulations between the two anesthetics (41.58 mC+/-13.6 mC, versus 41.58 mC+/-11.1 mC, p=1.00). CONCLUSION: During the ECT of patients with schizophrenia, propofol was shown to possess significant seizure-shortening properties, but it does not elevate seizure threshold or drop seizure duration under the minimal threshold more frequently than etomidate does. Based on these findings, we conclude that the use of propofol does not result in a greater electric load on the patients than etomidate. SN - 1419-8711 UR - https://www.unboundmedicine.com/medline/citation/18399030/Comparison_of_propofol_and_etomidate_regarding_impact_on_seizure_threshold_during_electroconvulsive_therapy_in_patients_with_schizophrenia_ DB - PRIME DP - Unbound Medicine ER -