EFFECT OF METHOHEXITONE AND PROPOFOL WITH OR WITHOUT ALFENTANIL ON SEIZURE DURATION AND RECOVERY IN ELECTROCONVULSIVE-THERAPY

We have studied the effects of methohexitone and propofol with and wit hout alfentanil on seizure duration and recovery in this observer-blin ded, prospective, randomized, crossover study involving 24 patients un dergoing electroconvulsive therapy (ECT). Each patient had four treatm ent sessions, and received the following four i.v. regimens in random order: methohexitone 0.75 mg kg(-1), methohexitone 0.50 mg kg(-1) and alfentanil 10 mu g kg(-1), propofol 0.75 mg kg(-1), propofol 0.50 mg k g(-1) and alfentanil 10 mu g kg(-1) Additional methohexitone or propof ol was given as needed in 10-20-mg increments until loss of consciousn ess. Suxamethonium 1.0 mg kg(-1) i.v. was given for muscular paralysis . Mean motor and EEG seizure durations were longer with methohexitone- alfentanil (44.7 (SD 15.0) and 70.5 (29.7) s) than with methohexitone (37.6 (12.6) and 52.6 (15.3) s) and similarly, seizures were longer wi th propofol-alfentanil (36.8 (15.2) and 54.5 (20.9) s) than alone prop ofol alone (27.2 (11.9) and 39.2 (3.9) s). Seizures were longest with methohexitone-alfentanil and shortest with propofol. Recovery time was statistically shorter in patients receiving propofol compared with me thohexitone-alfentanil and methohexitone alone. Alfentanil with a redu ced dose of methohexitone or propofol provided unconsciousness and inc reased seizure duration in patients undergoing ECT. We conclude that t he combination of methohexitone with alfentanil is a good regimen for ECT, especially for patients with short seizure duration.