A prospective study to compare the effect of ketamine and sodium thiopental in drug resistant major depression
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 2
Abstract
Background: Major depression or major depressive order is characterized by persistent feeling of sadness or lack of interest in any outside stimulus. Electroconvulsive therapy (ECT) is one of the most successful options for treatment. It was observed that Ketamine and sodium thiopental both increased the seizure duration. The aim of present study was to compare the effects of ketamine and sodium thiopental in drug resistant. Methods: This study was double blind study and we included 100 patients who were diagnosed of drug resistant major depression according to Diagnostic and Statistical manual of Mental Disorders. Patients were divided into Group A and Group B where patients in Group A received ketamine 0.8 mg and patients in group B received sodium thiopental 1-21.5 mg/kg as the anestheic agent for induction. All the patients received 8 sessions of ECT divided as 3 times per week each lasting for 30-90 seconds. At the end of 2nd, 4th, 6th, 8th session patient’s recovery time and post anesthesia complications were recorded in 1st hour. Hamilton Depression Rating Scale (HDRS) was used to analyse the effect of these drugs on depression. The scoring on HDRS was done before the 1st ECT and at the end of 2nd, 4th, 6th and 8th session of ECT. Results: The side effects such as headache, nausea and fear of awakening illusions were significantly more in ketamine group in all the sessions (p value <0.05). The rise in both systolic and diastolic blood pressure was also significantly more in Ketamine group than in sodium thiopental group (p<0.05). Repeated measures of seizure duration showed a significant reduction of seizure duration with each successive session of ECT in both the groups. (p=0.02). The scoring of HDRS showed the decreasing trend in the scores with successive sessions of ECT more so in the ketamine group than in sodium thiopental group by the end of last session. Conclusion: Ketamine with premedication is a promising agent which can be used as induction agent of choice for ECT in patients with drug resistant major depression as there is clear improvement in the depression scores with repeated infusions of ketamine.
Authors and Affiliations
Mohammed Mukarram Iqbal, Ajay Dhage, Kaja Sriram Murthy
Keywords
Related Articles
- EP ID EP520970
- DOI 10.26611/1015924
- Views 159
- Downloads 0
Effect of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb orthopaedic surgeries
Background and Aims: Surgery evokes stress response resulting in increased secretion of counter-regulatory hormones (catecholamines, cortisol, glucagon, and growth hormone) and excessive release of inflammatory cytokines...
Comparison of Propofol and Thiopentone as anaesthetic agents for electroconvulsive therapy - A prospective, double blinded cross over trial
Background: The ideal anaesthetic agent for electroconvulsive therapy (ECT) should provide a smooth, rapid induction and recovery with minimal antagonistic effect on the seizure activity. We compared two induction agents...
A study of the hemodynamic responses to tracheal intubation with gabapentin and fentanyl and a combination of both at tertiary health care center
Background: Supraclavicular brachial plexus block is commonly used for upper limb surgeries due to its effectiveness, performance and margin of safety. To minimize the drawbacks of bupivacaine, adjuvants are usedto impro...
A comparative study of the efficacy of I.V. esmolol and megnesium sulphate in attenuating haemodynamic response to laryngoscopy and tracheal intubation
Problem Statement: The tracheal intubation is a powerful noxious stimulus. During laryngoscopy and tracheal intubation these is cardiovascular stress response. It occurs frequently and results in increased serum concentr...
A comparative study of combination of dexmedetomidine and midazolam versus combination of midazolam and fentanyl for modified radical mastoidectomy under monitored anaesthesia care
Background: Monitored anaesthesia care (MAC) has gained importance in anaesthesia for both diagnostic and therapeutic procedures in view of providing safe sedation, controlling patient’s anxiety and pain control. MAC typ...