Journal of Anesthesiology and Pain

Aim and Background: Today the effect of Electroconvulsive therapy (ECT)in cure of Major depressive disease (MDD), and psychiatric patients is well accepted and usage of this method is developed every day. In this regard, selecting the most effective hypnotic drugs in ECT and their therapeutic and hemodynamic effects seem very important and critical. Materials and Methods: In this study we selected 26 patients (gender was not important) with MDD who were candidate for ECT therapy with ASA<3. 13 patients received induction with ketamine and succinylcholine in first session and for second session received thiopental and succinylcholine the second group of 13 patients unlike the first group, received thiopental and succinylcholine in first session and in second they received ketamine and succinylcholine. In all patients we measured blood pressure, heart rate, and O2 saturation before induction, immediately after induction, 1st minute, 2nd minute, 4th minute, 10th minute post-induction, and after the patients were awake. Also we measured seizure and recovery duration and any possible complication. Findings: Considering heart rate, systolic blood pressure ,diastolic blood pressure, O2 saturation and recovery time we found no significant differences nor between the groups and neither in whole patients. However regarding seizure duration, we found significant difference between two groups and in all 26 patients. It was totally shown that seizure duration was longer with ketamine than thiopental. About complications we found only significant differences in myalgia which was seen in 12 cases of thiopental but 1 case of ketamine induction. Conclusion: Our findings show that ketamine prolongs seizure duration and it leads to no significant difference in hemodynamic parameters and less complications in comparison with thiopental. So it seems that ketamine is a better choice for anesthesia in ECT than thiopental.