The comparative effects of propofol versus thiopental on middle cerebral artery blood flow velocity during electroconvulsive therapy

Electroconvulsive therapy provokes abrupt changes in both systemic and cere bral hemodynamics. An anesthetic that has a minor effect on cerebral hemody namics might be more suitable for patients with intracranial complications, such as cerebral aneurysm. The purpose of our present study was to compare the effects of thiopental and propofol on cerebral blood flow velocity. We continuously compared cerebral blood flow velocity at the middle cerebral artery (MCA) during electroconvulsive therapy, using propofol (1 mg/kg, n = 20) versus thiopental (2 mg/kg, rt = 20) anesthesia. Systemic hemodynamic variables and flow velocity at the MCA were measured until 10 min after the electrical shock. Heart rate and arterial blood pressure increased in the thiopental group until 5 min after the electrical shock. In the propofol gr oup, an increase in mean blood pressure was observed to 1 min after the ele ctrical shock. Mean flow velocity at the MCA decreased after anesthesia in both groups, and increased at 0.5-3 min after the electrical shock in the t hiopental group and at 0.5 and 1 min after the shock in the propofol group. The flow velocities at 0.5-5 min after the electrical shock were significa ntly more rapid in the thiopental group compared with the propofol group.