Randomised, quadruple-blind crossover ECT study (n=24) comparing sevoflurane anaesthesia versus ketamine 1 mg/kg IV bolus on QTc and Tp-e intervals in patients with major depression.
Patients are randomised to receive sevoflurane or ketamine for their initial ECT session and then receive the alternate agent on the next session, alternating at each session through the sixth session.
Sevoflurane is given as inhaled induction at 8% then maintained at 2–4% until the electrical stimulus; ketamine is administered as a 1 mg/kg IV bolus. ECG, MAP and HR are recorded at baseline, after induction and at 0, 1, 3 and 10 minutes post-seizure; QT and Tp-e intervals measured by a blinded assessor.
Primary aim is to compare effects of the two anaesthetic strategies on QTc and Tp-e intervals in patients undergoing ECT for major depressive disorder.
Sevoflurane anaesthesia for ECT (initiated at 8% for induction, maintained 2–4% until stimulus).
Induction at 8% sevoflurane, maintenance 2–4% until electrical stimulus; volatile anaesthetic agent (sevoflurane).
Ketamine 1 mg/kg IV bolus for ECT.
1 mg/kg IV bolus administered for anaesthesia during ECT.