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Anesth Analg 2000;91:1531-1536
© 2000 International Anesthesia Research Society

GENERAL ARTICLES

The Comparative Effects of Propofol Versus Thiopental on Middle Cerebral Artery Blood Flow Velocity During Electroconvulsive Therapy

Shigeru Saito, MD, Yuji Kadoi, MD, Takeshi Nara, MD, Makoto Sudo, MD, Hideaki Obata, MD, Toshihiro Morita, MD, and Fumio Goto, MD

Department of Anesthesiology & Reanimatology, Gunma University School of Medicine, Maebashi, Japan

Address correspondence and reprint requests to Shigeru Saito, MD, Department of Anesthesiology & Reanimatology, Gunma University School of Medicine, 3-39-22, Showamachi, Maebashi, 371-8511, Japan. Address e-mail to shigerus{at}news.sb.gunma-u.ac.jp

Electroconvulsive therapy provokes abrupt changes in both systemic and cerebral hemodynamics. An anesthetic that has a minor effect on cerebral hemodynamics might be more suitable for patients with intracranial complications, such as cerebral aneurysm. The purpose of our present study was to compare the effects of thiopental and propofol on cerebral blood flow velocity. We continuously compared cerebral blood flow velocity at the middle cerebral artery (MCA) during electroconvulsive therapy, using propofol (1 mg/kg, n = 20) versus thiopental (2 mg/kg, n = 20) anesthesia. Systemic hemodynamic variables and flow velocity at the MCA were measured until 10 min after the electrical shock. Heart rate and arterial blood pressure increased in the thiopental group until 5 min after the electrical shock. In the propofol group, an increase in mean blood pressure was observed to 1 min after the electrical shock. Mean flow velocity at the MCA decreased after anesthesia in both groups, and increased at 0.5–3 min after the electrical shock in the thiopental group and at 0.5 and 1 min after the shock in the propofol group. The flow velocities at 0.5–5 min after the electrical shock were significantly more rapid in the thiopental group compared with the propofol group. {abs}

Implications: Cerebral blood flow velocity change, measured by transcranial Doppler sonography during electroconvulsive therapy, was minor using propofol anesthesia compared with barbiturate anesthesia. Propofol anesthesia may be suitable for patients who cannot tolerate abrupt cerebral hemodynamic change.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2000 by the International Anesthesia Research Society.