Comparision of Propofol and Thiopental for Electroconvulsive Therapy: Effects on Hemodynamic Changes and Intraocular Pressure / 대한마취과학회지

BACKGROUND: Electroconvulsive therapy (ECT) can produce dangerous complications, such as arrhythmias, transient hypertension, and increases in intraocular pressure. This study was designed to whether propofol, in comparision with thiopental, would attenuate these hypertensive responses and increases in intraocular pressure. METHODS: Twenty patients were studied during courses of ECT administrations, each patient receiving propofol or thiopental on different occasions. The induction dose was 1.6 mg/kg of propofol and 3 mg/kg of thiopental sodium. Mean arterial pressure, heart rate, cardiac rhythm and intraocular pressure were checked before induction (control), after administration of succinylcholine, immediately, 5 min, and 10 min after ECT administration. Recovery time was also compared between two groups. RESULTS: Mean arterial pressure was lower following propofol than thiopental (p<0.05) immediately after ECT. Heart rate was lower following propofol than thiopental (p<0.05) immediately, 5 min, and 10 min after ECT. Cardiac rhythm abnormalities were infrequent and not serious. Intraocular pressure was lower following propofol than thiopental (p<0.05) immediately, 5 min, and 10 min after ECT. Recovery time of propofol (6.5+/-0.8 min) was shorter than thiopental (7.5+/-0.9 min). CONCLUSIONS: Propofol for ECT induction would seem to be an ideal drug, as it attenuates hypertensive responses and increases in intraocular pressure.

Intracranial Hemorrhage in Eclamptic Patient undergoing Cesarean Section / 대한마취과학회지

Preeclampsia is defined as the development of hypertension with proteinuria, edema induced by pregnancy after 20th week of gestation. Eclampsia implies the occurrence of convulsions unrelated to any coexisting neurologic disease in a preeclamptic. The leading cause of maternal death in preeclampsia-eclampsia is intracranial hemorrhage. Other causes of morbidity include congestive heart failure with pulmonary edema, pulmonary aspiration of gastric contents, disseminated intravascular coagulation, acute renal failure, and septic shock. We experienced a case of death from intracranial hemorrhage in eclamptic patient undergoing cesarean section.