Comparing the Effects of Propofol-Ketamine to Propofol-Saline on Myalgia Post Electroconvulsive Therapy

Background and Myalgia is among the relatively common side effects of electroconvulsive therapy (ECT). Positive preventive analgesic effects of ketamine in surgical patients have been studied. However, the effects of ketamine on post-ECT myalgia are unclear. This study aimed to examine the effects of ketamine on myalgia in patients with depressive disorder who underwent ECT. According to the diagnostic and statistical manual of mental disorders forth edition (DSM-IV) criteria, 50 major depressive patients were included in a double blinded, cross-sectional clinical study at the second and third ECT sessions. They were randomly allocated into induction of anesthesia either with propofol 1 mg/kg plus ketamine 0.3mg/kg or with propofol 1 mg/kg plus 2ml 0.9% saline in first study ECT session and vice versa in the next ECT session. Paralysis was achieved with 0.5 mg/kg succinylcholine in two sessions. Assessments included post ECT myalgia, seizure duration, and hemodynamic profile. There were 50 patients, with a mean age of 37.8 years, who underwent 100 ECT sessions. The mean duration of seizures in the ketamine and saline group was 28 and 29 seconds, respectively, and the difference was not statistically significant. Ketamine did not significantly reduce the myalgia in compared to the placebo. Based on the results of our study, adding ketamine to propofol for induction of anesthesia in patients with major depression who undergo ECT has no effects on seizure duration and post ECT myalgia.