Psychiatric Bulletin (2004) 28: 326-328. doi: 10.1192/pb.28.9.326
© 2004 The Royal College of Psychiatrists
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Psychiatric Bulletin (2004) 28: 326-328
© 2004 The Royal College of Psychiatrists

Inhalation induction with sevoflurane for electroconvulsive therapy: a case series

James Palmer, Consultant in Anaesthesia

Department of Anaesthesia, Hope Hospital, Stott Lane, Salford, Manchester M6 8HD

Mohsen Khalil, SHO in Anaesthesia

Department of Anaesthesia, Hope Hospital, Salford

David Meagher, Consultant Psychiatrist

Departments of Psychiatry and Anaesthesia, Dumfries and Galloway Royal Infirmary and Crichton Royal Hospital, Dumfries

Correspondence: (e-mail: james.palmer{at}srht.nhs.uk)

AIMS AND METHOD

Until 1999, the most common drug for induction of anaesthesia for electroconvulsive therapy (ECT) in the UK was methohexital. Cessation of production left few choices of induction agent. Increased use of sevoflurane in short procedures suggests that it might be suitable as a sole agent for anaesthesia in ECT. We therefore induced anaesthesia in five consecutive patients undergoing ECT to assess sevoflurane’s potential for this use. We recorded vital signs, needle phobia, face-mask toleration, duration of induction, seizure duration and recovery variables.

RESULTS

Anaesthesia was successfully induced in all patients without difficulty. One patient experienced mild hypoxia following the seizure. Seizure duration ranged from 24 to 72 seconds. Recovery times to eye opening and times to ‘ward’ fitness were acceptable.

CLINICAL IMPLICATIONS

Sevoflurane may be a suitable alternative for induction of anaesthesia for ECT.