Investigation of Electroconvulsive Therapy Parameters in Propofol and Ketamine–Propofol Combination Anesthesia

Objective: It is aimed to highlight the concept of electrical stimulus [electroconvulsive therapy (ECT) dose], an aspect that has not received sufficient attention in previous research on ECT.

Methods: This study is a retrospective investigation aiming to examine the medical records of patients who received ECT. Patients were assigned to 2 groups. The first group received a dose of 1mg/kg propofol for ECT anesthesia (n=25), while the second group receives a combination of 0.5 mg/kg propofol and 0.5 mg/kg ketamine (n=36).The electrical charge required to induce an effective seizure and the parameters determining the electrical charge, such as pulse width, frequency, stimulus duration, and current, were recorded at each session and compared.

Results: In propofol group the initial value of frequency was 29.03 ± 7.35 Hz and the last value (frequence at eighth session) was 83.06 ± 24.45 Hz. The difference in frequency was found to be significantly increased in propofol group (F=151.95; ηp2=0.83; P < .0001). In propofol+ketamine group the initial value of frequency was 24.09 ± 7.42 Hz and the last value (frequence at eighth session) was 91.74 ± 22.39 Hz. The difference in frequency was found to be significantly increased in propofol group (F=237.05; ηp2=0.95; P < .0001). The duration of session was significantly decreased in propofol group (F=10.29; ηp2=0.28; P < .0001). The duration of the seizure in first session was 57.17 ± 19.09 seconds and the duration of seizure in eighth session was 50.78 ± 14.21 seconds in propofol+ketamine group. The duration of the session was significantly decreased in propofol+ketamine group.

Conclusion: It was observed that the ECT dose remained similar between the 2 groups. Further research is warranted to delve into the cognitive effects of the propofol+ketamine combination in ECT procedures.

Cite this article as: Beyazyüz E, Buse Codal E, Gültekin A, Yıldırım İ, Beyazyüz M. Investigation of electroconvulsive therapy parameters in propofol and ketamine–propofol combination anesthesia. Neuropsychiatr Invest. 2023;61(3):75-79.