Sevoflurane induction for electroconvulsive therapy (ECT)- a clinical review and cost analysis

Abstract

Objective: The search for an ideal induction agent for use in electroconvulsive therapy (ECT) has been a long one. To date numerous agents have been used and there is little uniformity in clinical practice regarding agent of choice. Recent reports in the literature suggesting the efficacy of the volatile anaesthetic agent sevoflurane for ECT have appeared. As a result of these reports the Tara ECT unit converted to sevoflurane for induction purposes, hence the need for both a clinical review and cost analysis.

Method: This report is a retrospective clinical chart review of all patients treated with sevoflurane induction over the course of the first year of its use in this ECT unit, together with a brief cost analysis comparison to the previous induction agent used.

Results: In our experience sevoflurane has been fairly well tolerated and has improved patient anaesthetic induction morbidity but appears to be associated with a shorter duration of motor seizure, potential haemodynamic complications and an increased financial burden for the hospital.

Conclusion: This report is from a naturalistic setting with most patients being on concomitant medications and suffering with various medical and psychiatric problems and thus should be generalizable to other ECT units.

South African Psychiatry Review Vol. 9(4) 2006: 223-228