Remifentanil/Thiopental Combination and Seizure Length in Electroconvulsive Therapy

In an effort to see if use of high-potency opioid combined with lower-than-usual dose barbiturate results in longer seizure length in electroconvulsive therapy, we retrospectively examined data from 56 patients. For each case, I seizure with thiopental alone and I with thiopental combined with remifentanil were compared. Longer mean electroencephalographic seizure length with the combination slightly missed statistical significance, whereas motor seizure duration was not statistically significantly different between the 2 strategies. We conclude that if thiopental is used for anesthetic induction in electroconvulsive therapy in the dose range described herein, modest dose reduction and combination with remifentanil does not reliably prolong seizure duration.