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Correlation of Seizure Duration to Anesthetic Dosage in Patients Undergoing Electroconvulsive Therapy

Background: Electroconvulsive therapy (ECT) has been performed under general anesthesia with muscle relaxants in psychotic patients by stimulating the brain with an electrical current.
Objective: To focus on the correlation between the anesthetic dosage and the seizure duration in successive therapeutic course. 
Materials and Methods: The present report was a retrospective study. After standard monitoring and pre-oxygenating with 100% oxygen, patients were administered with sodium thiopental 2 to 4 mg/kg and succinylcholine 0.5 to 1.0 mg/kg intravenously. Then psychiatrists discharged an amount of electricity as small as possible to trigger patients up to the therapeutic convulsion. The anesthetic dosage, the electrical current, and the seizure duration were recorded.
Results: One hundred thirty patients were included in the present study. The average dosage of sodium thiopental and succinylcholine in 6-session ECT were 2.6 to 2.7 mg/kg and 0.9 to 1 mg/kg respectively. These anesthetics as well as the electrical current showed significant increase (p=0.001). However, the seizure duration as evidenced by electroencephalogram appeared to decrease significantly (p=0.001) through the electroconvulsive course. Moreover, sodium thiopental showed a negative correlation coefficient that slightly related to the seizure duration; whereas, succinylcholine showed a positive, moderate relationship. 
Conclusion: Along the electroconvulsive course, the seizure duration correlated inversely with the anesthetic dosage. The dosages of sodium thiopental and succinylcholine were increased significantly; however, the seizure duration showed clinically decrease.
Keywords: Electroconvulsive therapy, Anesthesia, Anesthetic, Psychiatric patients