Objectives: To investigate the effect of adding remifentanil to propofol used in the induction of anesthesia in efficacy, and to investigate the cognitive adverse effects of electroconvulsive therapy (ECT) in the treatment of patients with severe mania.
Methods: Thirty-eight patients’ condition was diagnosed as manic episode by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and were prescribed ECT by their physicians were included in a double-blind study and were randomly allocated to receive premedication with either remifentanil-atropine (study) or saline-atropine (control). Induction of anesthesia was done with propofol (1 mg/kg) and succinylcholine (0.5 mg/kg) in all patients. Assessments included seizure duration, Young Mania Rating Scale (YMRS), Mini-Mental State Examination (MMSE), and immediate cognitive adverse effects.
Results: Twenty-nine patients with 98 ECT sessions completed treatment. There were no differences between the 2 groups in relation to age, sex, duration of disease, weight, marital status, seizure duration, YMRS, and MMSE. However, immediate cognitive adverse effects were significantly lower in remifentanil group.