Comparison of Ketamine Combine Propofol vs Propofol Anesthesia in Schizophrenia Electroconvulsive Therapy
Status:
Unknown status
Trial end date:
2021-04-20
Target enrollment:
Participant gender:
Summary
Electroconvulsive therapy (ECT) serves as an effective adjuvant modality for major depressive
disorder, schizophrenia, or bipolar affective disorder refractory to or contraindicated to
psychopharmacological treatment. Anesthetics have been introduced into ECT sessions to
alleviate ECT-inducing discomfort sensation, tachycardia, arrhythmia, hypertension, and
anxiety.
Propofol is able to rapidly cross the blood-brain barrier (BBB), which leads to rapid onset
of sedation and hypnosis. Meanwhile, propofol has hemodynamic depressant effect and
attenuates hypertensive surge during ECT. Characteristics mentioned above make propofol one
of widely used anesthetics for anesthetized ECT. However, propofol is also well known for
anticonvulsant property. Thus, dosage of electrical stimulus may be increased to achieve
ideal seizure quality in this setting, which also leads to higher risk of subsequent
cognitive impairment or other complications.
Ketamine has also been widely used in the induction of anesthesia for the treatment of major
depressive disease in recent years. It has been found to increase the permeability and
therapeutic effect of antidepressants. Compared to traditional Barbiturate drugs or propofol,
do not increase the threshold of electricity required by electroporation, which can reduce
the time required for symptom relief of those drugs, It is a viable alternative induction
drug.
There have been confirmed that ketamine combine propofol can be used for electroconvulsive
treatment in patients with major depression and bipolar disorder, and even better
Electroconvulsive quality can be obtained. Reduce the number of Electroconvulsive treatments
and reduce the duration of treatment. However, the current literature has not yet verified
the clinical benefit of ketamine combine propofol as an anesthetic induction drug in patients
with schizophrenia who are receiving electroconvulsive therapy, and it is worthy of further
study.
In the investigator's clinical practice, the purpose of this experiment is to explore:
compared with propofol base anesthesia alone, and the combine use of ketamine and propofol
may reduce the threshold of seizure, improve the quality of Electroconvulsive therapy and
shorten the course of treatment. The combine use and titrate the drugs helps to reduce the
side effects of both ketamine and propofol (such as cardiovascular side effects and positive
symptoms) , achieve better Electroconvulsive therapy and effects.