Effects of Sevoflurane and Ketamine on QT in Electroconvulsive Therapy
Randomised, quadruple-blind crossover ECT study (n=24) comparing sevoflurane anaesthesia versus ketamine 1 mg/kg IV bolus on QTc and Tp-e intervals in patients with major depression.
Detailed Description
Patients are randomised to receive sevoflurane or ketamine for their initial ECT session and then receive the alternate agent on the next session, alternating at each session through the sixth session.
Sevoflurane is given as inhaled induction at 8% then maintained at 2–4% until the electrical stimulus; ketamine is administered as a 1 mg/kg IV bolus. ECG, MAP and HR are recorded at baseline, after induction and at 0, 1, 3 and 10 minutes post-seizure; QT and Tp-e intervals measured by a blinded assessor.
Primary aim is to compare effects of the two anaesthetic strategies on QTc and Tp-e intervals in patients undergoing ECT for major depressive disorder.
Study Protocol
Preparation
Dosing
Integration
Study Arms & Interventions
Sevoflurane
experimentalSevoflurane anaesthesia for ECT (initiated at 8% for induction, maintained 2–4% until stimulus).
Interventions
- Placebovia Inhalation• per session
Induction at 8% sevoflurane, maintenance 2–4% until electrical stimulus; volatile anaesthetic agent (sevoflurane).
Ketamine
active comparatorKetamine 1 mg/kg IV bolus for ECT.
Interventions
- Ketamine1 mg/kgvia IV• per session
1 mg/kg IV bolus administered for anaesthesia during ECT.
Participants
Inclusion Criteria
- Inclusion Criteria:
- Unpremedicated
- American Society of Anesthesiologists (ASA) I–II
- Patients with major depression scheduled for ECT sessions
Exclusion Criteria
- Exclusion Criteria:
- Pregnant
- Permanent pacemaker
- Diabetes mellitus
- Atrial fibrillation
- Electrolyte imbalance
- Taking antiarrhythmics or β-blockers
Study Details
- StatusCompleted
- PhasePhase IV
- Typeinterventional
- DesignRandomizedquadruple Blind
- Target Enrollment24 participants
- TimelineStart: 2012-01-02End: 2013-01-05
- Compounds
- Topic