The comparison of the effects of anaesthetic agents on the duration of the attack in electroconvulsive therapy and on the hemodynamic response

Purpose: ECT is routinely used under the general anesthesia for the treatment of many psychiatric diseases especially major depression. The aim of ECT is to protect the hemodynamic stability during the attack of the disease and to make the duration of the attack longer. In our study, it was aimed to find out the most appropriate anaesthetic strategy for this purpose.Material and Method: 160 ECT treatments on the patients, 54 of which were female and 102 of which were male, between 18 and 60 years old were taken into this study and 4 different medicine combinations were compared. When each 4 group of patients were taken into the anaesthetic room, the heart rates, systolic, diastolic and average arterial pressures and the peripheric oxygen saturation values were measured and recorded. After Tiopental Sodium (2.5 mg/kg) + Suxamethonium Chloride (1 mg/kg) were induced to group I (n=40), Tiopental Sodium (2.5 mg/kg) + Rocuronium Bromide (0.3 mg/kg) were induced to group II (n=40), Propofol (1 mg/kg) + Suxamethonium Chloride (1 mg/kg) were induced to group III (n=40) and Propofol (1mg/kg) + Rocuronium Bromide (0.3 mg/kg) were induced to group IV (n=36), hemodynamic parameter data and peripheric oxygen saturation values were recorded before ECT, after ECT, on the 1st, 3rd, and 5th minutes and on the 5th minute after the patients were taken into the postoperative care unit. The data about the duration of the attacks, the starting time of the spontaneous inhalation, the time that the patients opened their eyes, the time that the patients started to response to simple commands and the adverse effects that were observed were recorded.Results: A statistical difference (p>0.05) was not found when the demographic features of the groups were compared. When the duration of the attacks were compared, it was seen that the duration of the attacks became shorter and a meaningful difference was found between them (p=0.002). When the hemodynamic data were compared, it was seen that the data changed in time and the processes of the groups were different (p<0.05). When the data of the duration of being gathered (the starting time of the spontaneous inhalation, the time that the patients opened their eyes, the time that the patients started to response to simple commands) were compared, these durations became longer in group II and group IV and a meaningful difference was found between them (p<0.05). The SpO2 data were found similar in terms of processing (p=0.288).Conclusion: Tiopental sodium can be preferred as it lengthens the duration of the attack in ECT. In spite of the fact that rocuronium bromide lengthens the duration of being gathered, it was judged that suxamethonium chloride can be used as an alternative muscle relaxant when its potential adverse affects and complications are consideredKey Words: Electroconvulsive therapy (ECT), the duration of the attack, hemodynamism, propofol, rocuronium bromide.