Comparision of Thiopentone Sodium and Propofol in ECT Anaesthesia

Byline: T. Omprakash, Mohd. Ali, B. Anand, M. Devi, P. Surender This Study is conducted to compare Thiopentone sodium with Propofol as induction agents for modified ECT in hundred patients of ASA Grl & ASA Gll in a randomized fashion divided into two groups of fifty each. The patients selected for both groups wherein PR>80/mt. & B.P>90/60 mmHg. Group 'T' (n=50) received injection Thiopentone sodium 3 to 5 mg/Kg body weight and Group 'P' (n=50) received Propofol 1.5 to 2 mg/Kg body weight. Anticholinergic agents were used depending on the pulse rate. Patients with pulse rate 100/mt. were used Glycopyrrolate 0.2 mg, Scoline is given in the dose of 0.5mg/Kg body weight. The Seizure duration is observed following application of stimulus, after normal latent period of 2 to 3 seconds tonic - clonic movements were observed in the both groups of the drugs normal Seizure is observed. When there is no Seizure following optimal stimuli only the " Masseter Spasm " is observed which is correlated with other parameters like decreased oxygen saturation , initial bradycardia followed by tachycardia, Conjunctival congestion, pupillary dilation and EEG changes signifies that patient has attained a normal Seizure. The recovery pattern is observed by the following parameters *Establishment of spontaneous ventilation *Pulse rate *Blood pressure ( Systolic and diastolic) *Tone of the muscles *Orientation to time and space. ECT has been widely recognized and accepted treatment modality for various Psychiatric Ailments. With the use of Succinyl Choline by Wanderdel in 1951 modified ECTs came into existence. Use of General Anaesthesia led to the reduced incidence of Physical & Psychological trauma. The Ideal IV agent used for Modified ECT should provide 1. Rapid onset, 2. Short duration of action, 3. Attenuation of adverse Physiological effects of ECT, 4. Rapid recovery and 5. No adverse shortening of seizure duration [sup] [8] ;[sup] Methohexitone offers rapid induction and recovery from anaesthesia along with cardiovascular stability and has advantage over Thiopentone regarding seizure duration. Due to non availability of methohexitone Thiopentone was being used till date for all MECTs despite of its side effects like prolonged wakening time, arrhythmias & laryngeal spasm. Recent introduction of Propofol seems to be promising, as it has rapid onset of action and better quality of recovery compared with Thiopentone. Propofol although is known to cause pain on injection and decrease seizure duration, it does not have any adverse effects on therapeutic outcome [sup] [4] . [sup] Considering all these aspects present study was designated to evaluate Propofol as an induction agent for MECT and compare it with equivalent dose of Thiopentone. Material & Methods After careful pre-anaesthetic evaluation 100 patients in the age group of 15 to 50 years of either sex, ASA grade I or II who requires MECTs were included in the study. Informed consent was obtained from the patients and care takers in the prescribed form. Patients by simple random sampling were divided into 2 groups of 50 each. After the intial ECT patients who were on thiopentone were crossed over to Propofol for the next ECT administration. Thus after the cross over a total 50 patients in two groups completed the study. Group T received Thiopentone Sodium in the dose of 3-5 mg/Kg body weight and Group P received Propofol 1.5 - 2 mg/Kg body weight [sup] [9] . [sup] Monitoring of Systolic BP, Diastolic BP, Heart rate and Hb Oxygen saturation (SPO2) was done. After starting IV line patients with PR100/mt were given Glycopyrollate 0.2 mg admixed with either Thiopentone or Propofol. Irrespective of the medication that the patient is taking. …