Inhalation induction with sevoflurane for electroconvulsive therapy: A case series

Aims and methods. Until 1999, the most common drug for induction of anaesthesia for electroconvulsive therapy (ECT) in the UK was methohexital. Cessation of production left few choices of induction agent. Increased use of sevoflurane in short procedures suggests that it might be suitable as a sole agent for anaesthesia in ECT. We therefore induced anaesthesia in five consecutive patients undergoing ECT to assess sevoflurane's potential for this use. We recorded vital signs, needle phobia, face-mask toleration, duration of induction, seizure duration and recovery variables. Results. Anaesthesia was successfully induced in all patients without difficulty. One patient experienced mild hypoxia following the seizure. Seizure duration ranged from 24 to 72 seconds. Recovery times to eye opening and times to 'ward' fitness were acceptable. Clinical implications. Sevoflurane may be a suitable alternative for induction of anaesthesia for ECT.