A comparative study on the effects of thiopental and ketamine, in patients under electroconvulsive therapy

The anestheic drugs used in electroconvulsive therapy (ECT) have some defects such as pains and edema at the site of injection or short thiophantal is sometimes used. Duration of convulsion, premature ventricular construction and sinus bradycardia. This study was performed to compare the effects of ketamine and thiopental on duration of convulsion, homodynamic changes, and recovery time in patients undergoing ECT. This randomized double blind clinical trial was conducted on 16 patients in Noor Medical Center in Isfahan Iran. In the first time of ECT, ketamine 1 mg/kg ketamin (K group) as well as midazolam was administered. In the second time of ECT, 2.5 mg/kg thiopental (T group) was injected instead of thiopental. (Half patients received thiopental at first sescion and the others ketamin). The duration of convulsion observed with EEG monitoring, and systolic blood pressure, diastolic blood pressure and pulse rate before intervention and also immediately after ECT and 3, 5, 10, 15 minutes after ECT were recorded in all patients. Data were analyzed using t test, Chi square and ANOVA. The mean convulsion time in group T was 26.3±5.8 and group K was 32.4±6.4 seconds, (P<0.001). The duration between ECT and awakeness in T group was 5.40±1.3 and in K group was 7.5±2.5 minutes respectively (P<0.01). In group K, Systolic blood pressure. 3 and 5 minutes after ECT were significantly higher than the group T (P<0.05). Ketamine for anesthesia in electroconvulsive therapy can increase duration of convulsion. Elevation of arterial blood pressure and heart rate was seen after ECT with ketamin. Recovery time also prolonged after anesthesia with ketamine. Thus, ketamine may be used for anesthesia in psychological patients with intractable response to ECT.