Journal article
Electroconvulsive Therapy Anesthetic Choice and Clinical Outcomes
The journal of ECT, v 39(2), pp 102-105
01 Jun 2023
PMID: 36729716
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
ObjectiveEtomidate and methohexital are the 2 commonly used anesthetics for electroconvulsive therapy (ECT) in the United States. The objective of this study was to examine how anesthetic choice between etomidate and methohexital is associated with real-world clinical outcomes.MethodsThis naturalistic retrospective cohort study examined longitudinal electronic health records for 495 adult patients who received 2 or more ECT treatments from 2010 to 2019 in Kaiser Permanente North California, a large integrated health care system. Study outcomes included 12-month posttreatment depression remission as measured by the 9-item Patient Health Questionnaire, psychiatric and all-cause emergency department visits, and psychiatric and all-cause hospitalizations.ResultsAnesthetic choice was not significantly related to depression severity, emergency department visits, or psychiatric hospitalizations at 12 months after completing ECT. In exploratory analyses, we found that etomidate compared with methohexital was associated with higher rates of patient discomfort adverse effects-postictal agitation, phlebitis, and myoclonus (2.4% vs 0.4%; P < 0.001).ConclusionsWe present the first large comparison of etomidate and methohexital as anesthetics for ECT and their associations with real-world outcomes. Our study showed no significant difference on depression remission, emergency department visits, or hospitalizations 12-months posttreatment. Thus, clinicians should focus on other patient or treatment characteristics when deciding on anesthetics for ECT. Further investigation is needed to confirm our exploratory findings that etomidate use was correlated with a higher rate of patient discomfort adverse effects relative to methohexital.
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Details
- Title
- Electroconvulsive Therapy Anesthetic Choice and Clinical Outcomes
- Creators
- Kevin J. Li - University of California, San FranciscoNatalie E. Slama - Kaiser PermanenteMatthew E. Hirschtritt - University of California, San FranciscoPrachi Anshu - Drexel Univ, Coll Med, Philadelphia, PA USAEsti Iturralde - Kaiser Permanente
- Publication Details
- The journal of ECT, v 39(2), pp 102-105
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 4
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000995034200011
- Scopus ID
- 2-s2.0-85160455291
- Other Identifier
- 991021861196304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Behavioral Sciences
- Psychiatry