ABSTRACT
Fifty-eight patients with major depression were randomly assigned to receive a hypnotic dose of either propofol or methohexital for their complete treatment series of electroconvulsive therapy (ECT). As expected, seizure duration was significantly shorter with propofol than with methohexital anesthesia. Both groups recovered from their depression at the same rate. There was a significant improvement in the Hamilton Rating Scale for Depression scores between the first and last ECT session. However, this was independent of the choice of propofol or methohexital as the anesthetic. This study supports previous reports that seizure duration does not influence recovery from depression.
Subject(s)
Anesthesia, General , Anesthesia, Intravenous , Depressive Disorder/therapy , Electroconvulsive Therapy/methods , Methohexital , Propofol , Adolescent , Adult , Aged , Aged, 80 and over , Depressive Disorder/psychology , Electroencephalography/drug effects , Female , Humans , Male , Middle Aged , Personality Inventory , Treatment OutcomeABSTRACT
During the postanesthesia recovery period, surgical patients often exhibit an increased arterial blood pressure. Although these transient increases in blood pressure are usually benign, significant morbidity and mortality may result from complications of postoperative hypertension. The purpose of this study was twofold: to determine the frequency of postoperative hypertension in one particular recovery room, and to determine the efficacy of labetalol as an antihypertensive drug in this setting. This study included both a retrospective and prospective component. The retrospective portion involved review of 465 records of patients admitted to the recovery room at a large, private eastern medical college. Nearly 20% of patients admitted were found to have blood pressures in the range of our study's criteria for hypertension. Records were also reviewed for types of therapeutic interventions used to treat hypertension and determinations of their success or failure. The prospective portion of the study evaluated treatment protocols for postoperative hypertension with graduated intravenous injections of labetalol in 30 patients. Blood pressure was effectively controlled with an average of 25 minutes for all patients and remained effective for 24 hours postoperatively.
Subject(s)
Hypertension/drug therapy , Labetalol/therapeutic use , Postoperative Complications/drug therapy , Recovery Room , Adult , Aged , Female , Humans , Hypertension/epidemiology , Incidence , Male , Middle Aged , Prospective Studies , Retrospective StudiesABSTRACT
A careful preoperative history can be helpful in detecting problems with previous anesthetic experiences. However, it has been found that in the patients who have developed a complete syndrome of malignant hyperthermia (MH), 30% had prior uneventful general anesthesia. It is therefore of extreme importance when delivering anesthesia to recognize the signs of MH early in order to initiate correct procedures to prevent the development of a fulminating crisis of MH.
