None listed
Conditions
Brief summary
Major depressive disorder (MDD) is a heterogeneous and highly prevalent mood disorder. MDD is defined by low mood and energy, inability to experience enjoyment, changes to eating and sleep patterns, feeling of guilt or worthlessness, and suicidal thoughts. MDD is associated with excess mortality and increased risk of suicide. There are numerous etiological theories about MDD. Dysregulation of the inhibitory amino acid neurotransmitter gamma-aminobutyric acid (GABA) is one of these theories that involved in the etiology of MDD. The potential connection between GABA physiology and MDD was investigated by several researchers. Earlier studies showed that GABA concentrations were reduced in the cerebrospinal fluid of MDD patients. Central nervous system(CNS) GABA concentrations which were measured by magnetic resonance spectroscopy, are reduced in some MDD patients recently. The GABA system is also suggested as a major substrate of anesthetic efficacy. Anesthetic requirement may differ in patients with MDD depending on an abnormal GABA content. The effect of abnormal GABA content on anesthetic requirement has not been studied on patients with MDD yet. In this study, we investigated whether MDD has any effect on anesthetic requirement.
Interventions
In all groups anesthesia was standardized and induced with propofol 2 mg/kg, muscle relaxation with rocuronium 0.5mg/kg by several anesthesiologists. Fentanyl was given to all patients intravenously as a bolus 1 mcg/kg before induction of anesthesia. Anesthesia was maintained with sevoflurane in a mixture of nitrous oxide 2L/min and oxygen 2L/min, and all patients were mechanically ventilated to maintain an ETCO2 concentration of 30-37 mmHg. The patients were divided into two groups by using the
In all groups anesthesia was standardized and induced with propofol 2 mg/kg, muscle relaxation with rocuronium 0.5mg/kg by several anesthesiologists. Fentanyl was given to all patients intravenously as a bolus 1 mcg/kg before induction of anesthesia. Anesthesia was maintained with sevoflurane in a mixture of nitrous oxide 2L/min and oxygen 2L/min, and all patients were mechanically ventilated to maintain an ETCO2 concentration of 30-37 mmHg. The patients were divided into two groups by using the Beck Depression Inventory(BDI). BDI is a 21-item self-administered scale measuring various symptoms of depression. It comprises 21 groups of statements describing the somatic and cognitive-emotional symptoms of depression. Each item consists of four alternative responses graded from 0 to 3 according to the severity of the symptom. The patients choose the response closest to their state during the past week. A sum score is counted, a higher score indicating more severe depression. If the BDI score was under 10, it was called as control group. Patients were consulted to the psychiatrist when the BDI score was 17 or more. The psychiatric assessment was performed using the Structured Clinical Interview for DSM-IV Axis 1 disorders (SCID-I) with a trained interviewer. Patients who had axis-II disorders. psychiatric depression and seasonal affective disorder were excluded. Patients whom were diagnosed as MDD by the psychiatrist, they were classified as MDD group. Beck Anxiety Inventory(BAI) was also applied to all patients. Anesthesia was administered by blinded study raters who did not know patient’s group allocation. None of the patients were premedicated. Patients were observed during surgery.
Sponsors
VEYSEL ERDEN
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Inpatients planning to undergo laparoscopic cholecystectomy as an elective surgery
Exclusion criteria
Patients having urgency about cholecystitis, renal failure, thyroid dysfunction, morbid obesity, obstructive sleep apnea, neurological dysfunction, alcoholism, anticonvulsants, antidepressants and opioids usage
Outcome results
None listed