Use of Ketamine vs Methohexital for Electroconvulsive Therapy (ECT) on Patient Recovery and Re-orientation Time

Study Overview
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Brief Summary
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When undergoing ECT treatments, patient recovery time and re-orientation time may be shorter using ketamine for induction than using methohexital.

Detailed Description
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ECT treatments are done under general anesthesia, and the induction is commonly done with methohexital. We will study whether using ketamine as an induction agent will result in a faster recovery time and quicker re-orientation time compared to using methohexital.

Official Title
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The Use of Ketamine Versus Methohexital for Electroconvulsive Therapy: A Cross-Over Comparative Study on Patient Recovery and Re-Orientation Time

Conditions
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Orientation, Post-anesthesia Recovery

Intervention / Treatment
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* Drug: Ketamine
* Drug: Methohexital


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients eligible for ECT with a primary mood disorder (bipolar disorder, major depressive disorder) will be eligible to participate in this study. - Patients must have decisional capacity and must be able to consent for this study. Exclusion Criteria: patients with a primary psychotic disorder (schizophrenia, schizoaffective disorder); patients designated as having an American Society of Anesthesiologist (ASA) Status of greater than 3; patients with a known allergic reactions to methohexital , ketamine and succinylcholine; patients with current or previous history of aneurysms, intracranial bleeds, or intracranial hypertension; patients with uncontrolled severe hypertension.
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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ketamine First<br>This arm will receive ketamine for induction first, followed by alternating treatments between methohexital and ketamine | Drug: Ketamine<br>* Ketamine (1.5mg/kg) will be given for induction, with room to titrate up to induction effect<br>Drug: Methohexital<br>* Methohexital (1.5mg/kg) will be given for induction<br>|
| Experimental: Methohexital First<br>This arm will receive Methohexital first for induction, followed by alternating treatments between ketamine and methohexital. | Drug: Ketamine<br>* Ketamine (1.5mg/kg) will be given for induction, with room to titrate up to induction effect<br>Drug: Methohexital<br>* Methohexital (1.5mg/kg) will be given for induction<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Re-orientation Time | Patients will be scored based on 5 questions (name, age, year, day of week, location). Each patient will be scored prior to induction as to how many questions they score correctly. Patient is deemed re-oriented when they score the same as baseline after the treatment. | 1 hour | 
| Recovery Time | Recovery was assessed using 5 criteria (blood pressure, voluntary movement, oxygen requirement, consciousness, respiratory effort). Each criteria was scored from 0-2, with a full score of 10. The patient is scored at baseline, and is deemed recovered when all criteria has reached baseline score again. | 1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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orientation, post-anesthesia recovery, electroconvulsive therapy