Increased propofol requirement during succeeding administrations for electroconvulsive therapy - 24/08/11

Doi : 10.1016/j.jclinane.2003.09.009

Yitzhak Cohen, MD ^a,^{*
Staff Anesthesiologist, Tel Aviv Sourasky Medical Center}, Eli Feldinger, MD ^b,^{†
Physician, Electroconvulsive Therapy Unit, Tel Aviv Sourasky Medical Center}, Daniel Ogorek, MD ^a,^{*
Staff Anesthesiologist, Tel Aviv Sourasky Medical Center}, Avi A Weinbroum, MD ^c,⁎, ^{‡
Director, Post-Anesthesia Care Unit, Tel Aviv Sourasky Medical Center}
^a Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
^b Electroconvulsive Therapy Unit, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
^c Post-Anesthesia Care Unit, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

^*Address correspondence to Dr. Weinbroum, Director, Post-Anesthesia Care Unit, Tel Aviv Sourasky Medical Center, 6 Weizman St., Tel Aviv 64239, Israel

Abstract

Study objective

To study patients' requirement for propofol dosages during the course of repeated deep sedation for electroconvulsive therapy (ECT).

Design

Prospective study.

Setting

Outpatient psychiatric clinic in a tertiary-care, university-affiliated, 1100-bed metropolitan hospital.

Patients

30 patients undergoing 5-day successive ECT for depression over a 1-month period.

Interventions

Propofol and subsequently succinylcholine were injected intravenously (IV) to obtain deep sedation and relaxation followed by a 60 ± 5 (SD) joules-ECT.

Measurements

The dosage that was required to deeply sedate the patients, the duration of the ECT, and interval of time to full wakefulness and coherent response were measured.

Main results

13 of 30 patients 1) required >100% increase in the dose of propofol to achieve the same pharmacological prerequisite sedative endpoint, starting from their third treatment onward; 2) there was a 35% abbreviated duration of the convulsive activity; and 3) there was a 21% shortened interval of time to full wakefulness and coherent communication, starting at the fourth propofol injection.

Conclusions

Repeated injections of propofol in patients undergoing ECT under deep sedation can induce a tolerance-like reaction to the drug.

Le texte complet de cet article est disponible en PDF.

Keywords : Electroconvulsive therapy, propofol, dosage, augmentation

Plan

Introduction

Materials and methods

Statistical analysis

Results

Discussion

Export

Vol 16 - N° 4

P. 282-285 - juin 2004 Retour au numéro

Article précédent

Nausea and vomiting after outpatient ACL reconstruction with regional anesthesia: are lumbar plexus blocks a risk factor?
Brian A Williams, Molly T Vogt, Michael L Kentor, Chiara M Figallo, Melissa D Kelly, John P Williams

| Article suivant

Small change in capnography led to the detection of an intravascular thrombus
Hubert J Schmitt, Tim Beckmann, Werner Lang

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

connectez-vous ou créez un compte

Increased propofol requirement during succeeding administrations for electroconvulsive therapy - 24/08/11

Abstract

Study objective

Design

Setting

Patients

Interventions

Measurements

Main results

Conclusions

Plan

Export citations

Fichier

Contenu

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL