Effectiveness of Thiopentone, Propofol and Midazolam as an Ideal Intravenous Anaesthetic Agent for Modified Electro Convulsive Therapy: A Comparative study

BACKGROUND : The study was designed to compare the effectiveness of thiopentone, propofol and midazolam as an ideal intravenous anaesthetic agent for modified electroconvulsive therapy. AIM OF THE STUDY: To compare the effect of iv thiopentone, propofol, midazolam on induction time, quality, hemodynamics, seizure duration, recovery time and changes in serum potassium level. STUDY DESIGN: Prospective randomized double blinded study. MATERIALS AND METHODS: After approval from institutional ethical committee, this study was conducted in 90 patients of ASA I and ASA II of either sex, aged 18-60 years. All patients were randomly allocated by computerized randomization table into three groups for MECT. Group I received Inj. Thiopentone 2.5% 5mg/kg (30 patients), group II received Inj. Propofol 1% 2mg/kg (30 patients), Group III received Inj. Midazolam 0.2mg/kg (30 patients) till the loss of consciousness. Blood pressure was applied to right arm and inflated to 100 mg of Hg above systolic BP to isolate the limb for monitoring motor seizure. Followed by Inj. Succinyl choline 0.5mg/kg was given. The induction time, seizure duration, side effects, changes in hemodynamic stability like HR, BP, changes in serum potassium level from baseline, duration of recovery (obeys oral commands, situp unaided and meet discharge criteria) was recorded. The results of this study was indicated that propofol is safe induction agent for MECT with significant advantage over thiopentone and midazolam with regard to hemodynamic changes, induction time and recovery from anaesthesia with lesser complication. CONCLUSION: Propofol in the dosage of 2mg/kg body weight IV can be safely used for MECT in ASA I and ASA II when compared to thiopentone 5mg/kg and midazolam 0.2mg/ kg. Fast, smooth induction, early recovery, better hemodynamic parameters, antiemetic property, without much changes in serum potassium level makes PROPOFOL as an agent of choice for day care procedure