Comparison of the Effect of Ketamine and Sodium Thiopental on Blood Pressure and Heart Rate during Electroconvulsive Therapy in Patients Admitted to the Ward of Psychiatry; A Double-Blind Randomized Clinical Trial

Electroconvulsive therapy (ECT) is one the most effective therapies for the treatment of patients with psychotic disorders. Ketamine increases the seizure duration after electroconvulsive therapy. However, the routine use of ketamine may be limited due to concerns about the side effects. The aim of this study was to compare the effect of ketamine and sodium thiopental on blood pressure and heart rate during and after electroconvulsive therapy.
The study included 64 patients who were candidates for receiving electroconvulsive therapy seizures. Consequently, patients were divided into two groups of 32 patients. Each patient received drug randomly. The collected data were analyzed using independent t and chi-square tests.
Findings: Mean arterial pressure (MAP) at the fifth (P = 0.001) and tenth (P = 0.003) minutes after the seizures was higher in ketamine group. Mean heart rate at the first (P = 0.020), fifth (P = 0.001) and tenth (P = 0.002) minutes after the seizures was significantly greater in ketamine group, too. In addition, the duration of seizures in ketamine group was significantly higher than the sodium thiopental group (P = 0.001).
Although, anesthesia induced by ketamine during electroconvulsive therapy increased blood pressure, heart rate and seizure duration, but due to lower medical complication, ketamine is an appropriate option for anesthesia in electroconvulsive therapy.