2015 issue 2


Volume 31, issue 2

Original article

The effect of ketamine anesthesia for electroconvulsive therapy on the level of brain natriuretic peptide

Krystian J. Wiśniewski1, Miłosz Krzywotulski1, Alicja Bartkowska-Śniatkowska2, Maria Chłopocka-Woźniak1, Janusz Rybakowski1
1. Uniwersytet Medyczny w Poznaniu, Klinika Psychiatrii Dorosłych
2. Uniwersytet Medyczny w Poznaniu, Klinika Anestezjologii i Intensywnej Terapii Pediatrycznej
Farmakoterapia w Psychiatrii i Neurologii 2015, 31 (2), 169–176
Date of publication: 25-09-2015
DOI: http://dx.medra.org/10.17393/fpn.2015.07.001
Keywords: electroconvulsive therapy, ketamine, thiopental, brain natriuretic peptide, drug-resistant depression


Aims. A demonstration of therapeutic effect of ketamine infusion in depression initiated the attempts of using it as an anaesthetic agent for electroconvulsive therapy (ECT). As ketamine exerts significant influence on the heart and circulatory system, the aim of this study was to assess it by measuring serum concentration of brain natriuretic peptide (BNP) in patients for whom thiopental was used in all ECT sessions, compared to those for whom ketamine was used in 5 out of 10 sessions.

Material and methods. The study was performed on 27 patients (11 males, 16 females) aged 21–81 years (mean 54±15), treated for drug-resistant depression or drug-resistant schizophrenia (1 patient) in the Department of Adult Psychiatry, Poznań University of Medical Sciences, between 2013-2014. Each patient had at least ten ECT sessions. In the first group (16 patients), 2–5 mg/kg of thiopental was used as an anaesthetic for all sessions and in the second group (11 patients) – 1.0–1.5 mg/kg of ketamine was used for the 2nd, 4th, 6th, 8th, and 10th session. Measurements of BNP were performed prior to and after the 2nd, 6th and 10th sessions.

Results. No significant difference was found taking into consideration the BNP levels between the group with thiopental anaesthesia alone and the group with alternating anaesthesia of thiopental and ketamine. Either, no significant difference was observed while comparing successive BNP levels during the course of ECT within each group.

Conclusions. The results show that BNP levels reflecting the load of circulatory system are similar for patients with alternating anaesthesia with thiopental and ketamine as in patients having anaesthesia with thiopental alone.

Address for correspondence:
Uniwersytet Medyczny w Poznaniu
Klinika Psychiatrii Dorosłych
ul. Szpitalna 27/33
60-572 Poznań, Poland
phone: +48 792 223 757
email: kwis85@gmail.com