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Published on: August 15, 2017
Impact of Anesthesia on Electroconvulsive Therapy-Related Impairments in Global Cognitive Function in Patients With
Léo Bernardoff1, Martin Blay, Dimitri Thellier2
1Vinatier Hospital Center, Bron, France.
Introduction:
Electroconvulsive therapy (ECT) in patients with treatment-resistant depression frequently leads to impairments in global cognitive function. Propofol and etomidate are the 2 most frequently used drugs for anesthetic induction during ECT. However, only few studies compared their differential impact on ECT-related impairments in global cognitive function.
Methods:
We studied retrospectively 75 patients hospitalized at Centre Hospitalier Le Vinatier (Bron, France) who met the DSM-V criteria for major depressive disorder and were treated with bilateral ECT to compare the effects of propofol and etomidate on ECT-related cognitive impairment. Global cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), and symptom severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS), both before and after treatment. The primary endpoint of the study was the change in MoCA score.
Results:
We found no significant difference in MoCA score variation between the etomidate and propofol groups. There were also no significant differences in MADRS score variation, responder, remission rate or ECT parameters between the 2 groups (except duration of electroencephalogram crisis).
Conclusions:
In this retrospective study, choice of etomidate or propofol as anesthetic agent had no impact on the adverse effects associated with ECT on global cognitive function in patients with treatment-resistant depression.
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