IS ADDITION OF FENTANYL TO PROPOFOL USEFUL DURING ELECTROCONVULSIVE THERAPY?

Purpose: This study was designed to investigate the effect of addition of fentanyl to propofol on the patient outcome during electroconvulsive therapy. Patients Methods: The study comprised 60 patients randomly allocated into 2 equal groups: Group I (30 patients): received Propofol (1%) - 2 mg/kg. Group II (30 patients): received Propofol (1%) - 2 mg/kg + Fentanyl 1.5μg/kg. All the patients were monitored for changes in hemodynamics HR, SBP, DBP, arterial oxygen saturation, ECG changes and respiratory rate throughout the procedure. Besides induction time, quality of induction, seizure duration, side effects, and complications were also recorded in both groups. Duration of recovery was recorded from injection of intravenous anesthetic agent to time taken to meet discharge criteria. RESULT: The demographic data show non-significant difference between both groups. Mean duration of induction was shorter in Group II compared with Group I and the induction of anesthesia was smoother in group II compared to Group I. Incidence of complications during induction was less in group II in comparison with group I. After application of ECT, significant rise in HR, SBP, and DBP was observed in group I than group II. The seizure duration was shorter in Group II compared to Group I. The recovery of cognition, orientation and neuromuscular coordination was significantly faster in Group I than Group II. CONCLUSION: Addition of fentanyl to propofol during application of electroconvulsive therapy will shorten the duration of induction, decrease incidence of complications, decrease the sympathetic response to ECT, but the seizure duration will be short and the recovery will be prolonged.