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Ketofol in electroconvulsive therapy anesthesia: two stones for one bird

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Abstract

Purpose

Propofol and ketamine have become progressively popular in electroconvulsive therapy (ECT) anesthesia, although propofol shortened seizure duration and ketamine might cause cardiotoxicity, psychotic episodes, and delayed recovery. Ketofol is a combination of ketamine and propofol, and the current study was designed to evaluate the effect of ketamine, propofol, and ketofol on hemodynamic profile, duration of seizure activity, and recovery times in patients undergoing ECT.

Methods

Ninety patients (44 women, mean age 27.8 ± 7.2 years) in one ECT session were enrolled and randomized to the propofol, ketamine, or ketofol group. Hemodynamic profile duration of seizure activity and recovery times were recorded.

Results

Motor seizure duration in the propofol group was significantly decreased compared to other groups (p < 0.001), whereas spontaneous breathing time in the ketamine group statistically increased compared to the propofol group (p = 0.001), and also eye-opening time (p < 0.001) and obeying-command time (p < 0.001) was significantly increased in the ketamine group compared to other groups. Heart rate (HR) at induction (ketamine 91.2 ± 13.6 vs. propofol 77 ± 13.4 and ketofol 79.9 ± 15.6; p < 0.013; p < 0.08, respectively) was statistically significantly increased in the ketamine group compared to other groups, and HR at the third minute (ketamine 92 ± 12.9 vs. propofol 79.4 ± 9.3 and ketofol 81.5 ± 14.2; p < 0.012, p < 0.048) was also statistically significantly increased in ketamine group compared to other groups.

Conclusion

The ketofol 1:1 mixture is associated with longer mean seizure time than propofol, and shorter mean recovery times than ketamine, with better hemodynamic stability, without any important side effects in ECT anesthesia.

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Yenişehir Yerleşkesi, 63300, Şanlıurfa, Turkey

    Saban Yalcin, Harun Aydoğan, Ahmet Kucuk, Hasan Husnu Yuce & Tekin Bilgiç

  2. Department of Pyschiatry, Harran University Medical Faculty, Şanlıurfa, Turkey

    Salih Selek & Fatih Karababa

Authors
  1. Saban Yalcin
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  2. Harun Aydoğan
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  3. Salih Selek
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  4. Ahmet Kucuk
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  7. Tekin Bilgiç
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Correspondence to Saban Yalcin.

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Yalcin, S., Aydoğan, H., Selek, S. et al. Ketofol in electroconvulsive therapy anesthesia: two stones for one bird. J Anesth 26, 562–567 (2012). https://doi.org/10.1007/s00540-012-1378-6

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  • DOI: https://doi.org/10.1007/s00540-012-1378-6

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