Influence of propofol dose and blood components on duration of electrical seizures in electroconvulsive therapy

被引:0
作者
Gonzalez Moral, Maria Luisa [1 ]
Selva Sevilla, Carmen [2 ]
Romero Rodenas, Patricia [3 ]
Tolosa Perez, Maria Teresa [3 ]
Lucas Perez-Romero, Marta [3 ]
Domato Lluch, Mar [3 ]
Geronimo Pardo, Manuel [4 ]
机构
[1] Hosp Gen Villarrobledo, Dept Anal Clin, Albacete, Spain
[2] Univ Castilla La Mancha, Fac Econ, Albacete, Spain
[3] Complejo Hosp Univ Albacete, Dept Salud Mental, Albacete, Spain
[4] Complejo Hosp Univ Albacete, Dept Anestesiol, Albacete, Spain
来源
REVISTA BRASILEIRA DE ANESTESIOLOGIA | 2018年 / 68卷 / 06期
关键词
Electroconvulsive therapy; Propofol/administration and dosage; Albumin; Hematocrit; Seizures; PSYCHIATRY WFSBP GUIDELINES; BISPECTRAL INDEX; BIOLOGICAL TREATMENT; WORLD FEDERATION; PHARMACOKINETICS; BINDING; PHARMACODYNAMICS; PARAMETERS; SOCIETIES; ECT;
D O I
10.1016/j.bjan.2018.03.005
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background and objectives: Propofol is commonly employed as a hypnotic agent to perform electroconvulsive therapy, but it exhibits also anticonvulsant properties. The main objective was to study the effect of the weight-adjusted dose of propofol on duration of the electrical seizure. Secondary objectives were to study the effect of absolute dose of propofol on duration of electrical seizure, the effect of both absolute and weight-adjusted doses on values of bispectral index, and the influence of blood chemistry on anticonvulsant effect. Methods: After approval of the Institutional Review Board, a retrospective chart review was performed of all patients who underwent at least one electroconvulsive therapy session. Multiple lineal regression analysis adjusted for potential confounders was employed to explore the effect of propofol dosage on values of bispectral index and on duration of seizure; bivariate correlation analyses were previously performed to identify variables fulfilling confounding criteria, specifically values of Spearman's rho >0.10. Results of regression analysis were expressed as B coefficient with its 95% confident interval. Results: 76 patients received 631 acute phase sessions. Propofol showed a statistically significant negative effect on duration of seizure (specifically a reduction of 4.081 s for every mg.kg(-1) of propofol; CI95%: -7906 to -0.255, p= 0.037) but not on bispectral index values. Slight anemia and hypoalbuminemia were very infrequent conditions, and the anticonvulsant effect was not influenced by these parameters. Conclusions: Propofol weight-adjusted dose is negatively related to duration of seizures. It should be carefully titrated when employed to perform electroconvulsive therapy. (C) 2018 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.
引用
收藏
页码:564 / 570
页数:7
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