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Updated: Jul 20, 2026

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Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Anesthesia and electroconvulsive therapy: a retrospective study comparing etomidate and propofol
Anish S Patel1, Caroline Gorst-Unsworth, Richard M Venn
1Meadowfield ECT Department, Meadowfield Hospital, UK.
The Journal of ECT
|September 8, 2006
Summary
Etomidate may be a better anesthetic choice for electroconvulsive therapy (ECT) than propofol. Patients receiving propofol required more treatments and had longer hospital stays, though both agents were equally safe.
Area of Science:
- Neuroscience
- Anesthesiology
- Psychiatry
Background:
- Anesthetic choice impacts electroconvulsive therapy (ECT) efficacy.
- Propofol, a common ECT anesthetic in the UK, is linked to higher stimulus charge and shorter seizures.
- Etomidate is an alternative, but safety concerns exist.
Purpose of the Study:
- Compare propofol and etomidate in real-world ECT settings.
- Assess effects on ECT course length, adverse events, missed seizures, and stimulus charge.
- Determine the optimal anesthetic induction agent for ECT.
Main Methods:
- Retrospective naturalistic study design.
- Analyzed 65 patients undergoing ECT over 36 months.
- Compared 36 patients receiving etomidate to 29 receiving propofol.
Main Results:
- Propofol group experienced significantly longer ECT courses.
- Higher seizure thresholds and increased electrical stimulus charge (mC) were observed with propofol.
- No significant differences in adverse events between etomidate and propofol.
Conclusions:
- Propofol and etomidate are equally tolerated for acute ECT.
- Propofol use correlated with longer, more costly inpatient stays.
- Etomidate presents a potentially superior alternative anesthetic for ECT.
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