A survey of methohexitone use by anesthetists in the clinical practice of ECT in Edinburgh

The dosage of methohexitone (methohexital) administered by anesthetic staff was surveyed in a consecutive series of 52 patients referred for electroconvulsive therapy (ECT) in routine clinical practice in Edinburgh. Patients were weighed before the first treatment, and the ratio of administered dose to weight in kilograms calculated. Anesthesia was administered by three consultant staff and six nonconsultant staff. In only one patient (2%) was the administered dose within the range recommended by the Royal College of Psychiatrists (0.75-0.9 mg/kg), and in only four patients (8%) were the doses within the range recommended by the American Psychiatric Association (0.75-1.0 mg/kg). In all other patients the dose exceeded these recommended ranges; the average dose was 1.5 (+/- 0.3) mg/kg. The possible implications of these findings are discussed.