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Increased propofol requirement during succeeding administrations for electroconvulsive therapy.
Yitzhak Cohen1, Eli Feldinger, Daniel Ogorek
1Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Journal of Clinical Anesthesia
|July 21, 2004
Summary
Repeated propofol use for electroconvulsive therapy (ECT) sedation may lead to tolerance. Patients required higher propofol doses and experienced shorter ECT durations and faster recovery times with subsequent treatments.
Area of Science:
- Anesthesiology
- Neuroscience
- Pharmacology
Background:
- Deep sedation with propofol is used for electroconvulsive therapy (ECT).
- The effects of repeated propofol administration in the context of ECT are not fully understood.
Purpose of the Study:
- To investigate propofol dosage requirements during repeated deep sedation for ECT.
- To assess changes in ECT duration and recovery time with repeated propofol administration.
Main Methods:
- Prospective study conducted in an outpatient psychiatric clinic.
- 30 patients undergoing 5 consecutive days of ECT for depression were included.
- Propofol and succinylcholine were administered intravenously for deep sedation and muscle relaxation prior to ECT.
Main Results:
- 13 out of 30 patients required over 100% more propofol from the third ECT treatment onwards.
- A 35% reduction in convulsive activity duration was observed.
- A 21% shorter interval to full wakefulness and coherent communication was noted from the fourth treatment.
Conclusions:
- Repeated propofol administration during ECT may induce a tolerance-like effect.
- This tolerance may impact anesthetic requirements and patient recovery.
- Further research is needed to understand the implications of propofol tolerance in ECT settings.