Understanding How Anaesthesia Affects ECT Outcomes

Study Overview
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Brief Summary
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This study will examine how anaesthetic technique affects ECT outcomes. Specifically, the investigators will examine how: 1) the time interval between anaesthetic and ECT stimulus, and 2) the ventilation rate before ECT stimulus, impacts on the quality of the EEG (this is a recording of brain activity during ECT and is used to judge the quality of a seizure and to guide individual patient dosing).

Detailed Description
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This study aims to examine how the time interval between administration of anaesthetic agent and ECT stimulus delivery impacts upon measures of EEG quality (seizure quality).

Official Title
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Understanding How Anaesthesia Affects ECT Outcomes

Conditions
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Depression

Intervention / Treatment
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* Other: Electroconvulsive Therapy (ECT) time interval + Anaesthetic (Thiopentone)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients treated with a course of ECT Exclusion Criteria: Use of non-standard anaesthetic agents in ECT (e.g. ketamine)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Each participant will receive all four treatment conditions in randomly allocated sequence during their ECT course. That is, participants will receive either short or long anaesthetic-ECT stimulus time interval treatments, and normal or hyperventilation treatments - this results in four possible combinations, which individual participants will cycle through in random order during their ECT course (e.g. short-hyperventilation, long-normal ventilation, short-normal ventilation, long-hyperventilation).
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Short time interval + Normal ventilation<br> | Other: Electroconvulsive Therapy (ECT) time interval + Anaesthetic (Thiopentone)<br>* The intervention in this study is the time interval between anaesthetic administration and ECT stimulus<br>|
| Active Comparator: Short time interval + Hyperventilation<br> | Other: Electroconvulsive Therapy (ECT) time interval + Anaesthetic (Thiopentone)<br>* The intervention in this study is the time interval between anaesthetic administration and ECT stimulus<br>|
| Active Comparator: Long time interval + Normal ventilation<br> | Other: Electroconvulsive Therapy (ECT) time interval + Anaesthetic (Thiopentone)<br>* The intervention in this study is the time interval between anaesthetic administration and ECT stimulus<br>|
| Active Comparator: Long time interval + Hyperventilation<br> | Other: Electroconvulsive Therapy (ECT) time interval + Anaesthetic (Thiopentone)<br>* The intervention in this study is the time interval between anaesthetic administration and ECT stimulus<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EEG Seizure Quality Rating using the EEG Seizure Quality Rating Sheet utilised by MacPherson et al | EEG quality will be rated manually for each ECT treatment undertaken by a participant until the conclusion of their ECT course. This rating will be done using the EEG Seizure Quality Rating Sheet utilised by MacPherson et al - low dose lignocaine added to propofol does not attenuate the response to electroconvulsive therapy; Journal of Affective Disorders, 2010; 126: 330-333 | Outcome measures will be collected immediately after each ECT treatment from the first treatment until the end of the ECT course, an estimated total of four to six weeks for most participants | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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electroconvulsive therapy, anaesthesia