The purpose of this study is to determine whether subanesthetic dose of ketamine combined with propofol is superior to propofol anesthesia alone in improving cognitive function in depressive patients undergoing ECT
This randomised, double-blind, parallel-group trial (n=132) compares IV ketamine 0.3 mg/kg plus propofol 1.5 mg/kg versus propofol 1.5 mg/kg plus saline in patients receiving ECT to assess cognitive outcomes.
Rationale: ECT is effective for severe depression but often causes cognitive dysfunction; preclinical and early clinical data suggest subanesthetic ketamine may protect or improve cognition when combined with anaesthesia.
Primary outcome: cognitive function rated by the Mini-Mental State Examination (MMSE); procedures include IV infusions prior to ECT with standard succinylcholine muscle relaxation and bitemporal electrode placement.
Propofol 1.5 mg/kg plus ketamine 0.3 mg/kg administered separately by IV infusion; succinylcholine 1 mg/kg after loss of consciousness; bitemporal ECT performed.
IV infusion of ketamine 0.3 mg/kg
Propofol 1.5 mg/kg IV (given separately)
Propofol 1.5 mg/kg plus normal saline (placebo) administered separately by IV infusion; succinylcholine 1 mg/kg after loss of consciousness; bitemporal ECT performed.
Propofol 1.5 mg/kg IV
Normal saline [weight(kg)×0.3÷10] ml as placebo