Protocol To Study Different Doses Of Ketofol Anesthesia in ECT: Proposed study from China

Out on PubMed, from authors in China, is this paper:

Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol.

Chen X, Zhou R, Lan L, Zhu L, Chen C, Zhang X, Han J, Xia L.Neuropsychiatr Dis Treat. 2024 May 17;20:1107-1115. doi: 10.2147/NDT.S463028. eCollection 2024.PMID: 38774255

The abstract is copied below:

Objective: Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing comprehensive treatment outcomes for depression.

Study design and methods: This study was a prospective, randomized, controlled, double-blind trial involving subjects and evaluators. One hundred eleven patients scheduled for ECT were randomly assigned to three groups. In Group P, propofol at 1mg/kg was administered intravenously. In Group P+E, propofol at a dosage of 0.5mg/kg and esketamine at a dosage of 0.5mg/kg was administered intravenously. Patients in Group P+SE received propofol at a dosage of 0.75mg/kg and esketamine at a dosage of 0.25mg/kg. The same anesthesia protocol was used for the same patient until the end of the last treatment. The primary outcome measures were the Hamilton depression scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9), the Columbia-Suicide Severity Rating Scale (C-SSRS), and the Digit symbol substitution test (DSST). Secondary outcomes included length of hospital stay, readmission rate, hemodynamic status, recovery, and adverse events.

Discussion: This study aimed to compare the effects of propofol combined with different doses of esketamine for ECT. The results may provide a better choice for ECT anesthesia.

The articel is here.
And from the text:


This is just a teaser of a proposed protocol, although much of the article is written as if the study has already been conducted.
Ketofol, either with racemic ketamine or esketamine, may turn out to be the optimal ECT anesthesia induction combination. Add a little dexmedetomidine, and what a smooth treatment it will be!
We look forward to the results of this study...



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