Cognitive protective effect of subanesthetic ketamine anesthesia on elderly patients with depression undergoing electroconvulsive therapy: a prospective controlled clinical study

Abstract

Objective To investigate the efficacy and safety of low-dose ketamine in the treatment of elderly depressive patients with electroconvulsive therapy (ECT). Methods A total of 157 elderly patients with depression were randomly divided into propofol anesthesia group (P group) and propofol combined with ketamine group (KP group). Beside propofol anesthesia, the patients in the KP group were given ketamine (0.3 mg/kg) before each ECT treatment, while those from the other group same amount of normal saline. Global cognitive functions were assessed using the mini-mental state examination (MMSE), respectively at baseline, 1 d after the 1st, 2nd, 4th and 6th ECT sessions, and 1 d after the end of the ECT course. The electrical dose and seizure duration of each ECT and incidence of complications were recorded. Results There were no significant differences in MMSE scores between the 2 groups at above time points before and after ECT treatment (P>0.05), but the incidence of cognitive function impairment was lower in the KP group than the P group (10.4% vs 25.7%, P0.05). Conclusion Low dose ketamine is safe as an adjuvant anesthetic for elderly patients undergoing ECT and shows a protective effect on cognitive function.

Keywords

• aged
• electroconvulsive therapy
• cognitive function
• ketamine
• depression