Comparison of Recovery Time and Complications During the Use of Etomidate and Thiopental Sodium in Anesthesia in Children for Electroconvulsive Therapy; A Double Blind Randomized Clinical Trial
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Abstract
Background: Electroconvulsive therapy (ECT) is usually given to people with severe depression which has not responded to other forms of treatment such as anti-depressants. ECT may be accompanied by potentially significant medical complications including prolonged seizures, prolonged apnea, or cardiac or pulmonary complications. Modification of ECT with brief anesthesia and muscle relaxants should be accomplished. Present prospective randomized study is designed to compare Thiopental Sodium and Etomidate for their effect on hemodynamics, seizure duration, respiratory arrest, and recovery after electroconvulsive therapy and various adverse effects on Sick children in ECT.
Methods: A total of 64 patients with psychiatric disorder were examined in a prospective randomized double-blind study. The patients were randomly divided into two groups as group T (n= 32, Thiopental sodium 2 mg kg-1), and group E (n = 32, Etomidate 0.1 mgkg-1).
effects of etomidate versus thiopental in electroconvulsive therapy on cardiovascular system parameters (heart rate, blood pressure, and blood oxygenation), seizure variables, adverse effects and recovery variables were recorded at every session, on prespecified time points, and the findings were used in this evaluation.
The methods used were descriptive study, cross tabs, Chi-square test, independent sample t-test, paired sample t-test, Fisher and repeated measure analysis of variance (ANOVA). It should be noted, the results are statistically significant at 95% has been mentioned.
Results: Both groups were comparable in sex, weight and ASA physical status, with no statistically significant differences (p > 0.05). There was no difference in the Systolic blood pressure (DBP) between the two groups.
Patients in etomidate group showed little change in mean Diastolic blood pressure 5th minutes after ETC (DBP5) and mean arterial pressure 5th minutes after ETC (MAP5), and heart rate 1th minutes after ETC (HR1), arterial blood oxygen saturation 1 and 5 minutes after ETC, compared to thiopental (p> 0.05).
Based on statistical analysis, the relative superiority of etomidate compared to thiopental the anesthetic induction in the treatment of ECT, was seen in Four variables, duration of seizures, Recovery time, Reach verbal response after seizure and apnea durations (Back spontaneous breathing after a seizure).
In addition, Pain on injection, nausea and vomiting and Myoclonus was more in etomidate group while Muscular pain activity was higher in thiopental group (p> 0.05).
Conclusion: It seems that etomidate compared with thiopental has no conflict with ECT therapeutic effects in psychiatric patients. In addition, it probably can be used as a safe and effective drug for controlling ECT-induced hemodynamic changes and seizure variables. Drawback etomidate Compared with thiopental had a high incidence of myoclonus, Pain at injection site and nausea and vomiting.
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| Issue | Vol 3 No 1 (2017): Winter |
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| Section | Research Article(s) | |
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