Effect of low dose propofol combined with remifentanil on blood pressure during modified electroconvulsive therapy: a retrospective, single-center study

DOI
  • Shinjo Eriko
    Department of Anesthesiology, National Hospital Organization Kokura Medical Center
  • Shirozu Kazuhiro
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
  • Takamori Shinnosuke
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
  • Fukuchi Kaho
    Department of Anesthesiology, National Hospital Organization Kokura Medical Center
  • Ozasa Shoko
    Department of Anesthesiology, National Hospital Organization Kokura Medical Center
  • Kobayashi Atsushi
    Department of Anesthesiology, National Hospital Organization Kokura Medical Center
  • Cho Sungsam
    Department of Anesthesiology, National Hospital Organization Kokura Medical Center
  • Higashi Midoriko
    Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
  • Yamaura Ken
    Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University

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Introduction: Modified electroconvulsive therapy (m-ECT) is mainly used to induce seizures. The use of anesthetic agents during m-ECT should be minimized because they could inhibit the development of seizures. Modifying the method of administration of anesthetic in combination with opioid use is known to help in reduction of the anesthetic dose. However, the effect of this dose reduction on circulatory dynamics during m-ECT has not been studied in detail. Therefore, we conducted this study to investigate the changes in blood pressure associated with anesthetic dose reduction during m-ECT. <br>Methods: Ninety-one patients who underwent m-ECT eight or more times per course (455 m-ECT procedures in total) were included. The data were extracted retrospectively from anesthesia and electronic medical records from September 2015 to February 2020. The changes in blood pressure during m-ECT were compared between the following groups: propofol and remifentanil (PR group: remifentanil followed by propofol [1 µg/mL] based on target control infusion until loss of consciousness) and propofol alone (P group: propofol [2 µg/mL] based on target control infusion until loss of consciousness). <br>Results: Of the 455 procedures (91 patients), 325 (65 patients) were performed in the PR group and 130 (26 patients) in the P group. Systolic blood pressure ≥180 mmHg during m-ECT was significantly more in the PR group than in the P group (73/325 vs. 14/130, p＝0.004). <br>Conclusion: The use of a reduced dose of propofol in combination with remifentanil significantly increased blood pressure and the use of nicardipine than did propofol alone during m-ECT.

収録刊行物

  • 循環制御

    循環制御 43 (2), 71-76, 2022

    日本循環制御医学会

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