Etomidate versus Propofol for Motor Seizure Duration during Modified Electroconvulsive Therapy

Area of Science:

• Anesthesiology
• Neuroscience
• Pharmacology

Background:

• Certain anesthetic agents can negatively impact motor seizure duration due to their anticonvulsant properties.
• Etomidate and propofol, lacking strong anticonvulsant effects, may be suitable for electroconvulsive therapy (ECT).
• ECT requires short-acting anesthetics with rapid onset and recovery that do not interfere with seizure activity.

Purpose of the Study:

• To compare motor seizure duration between propofol and etomidate in modified ECT.
• To evaluate induction time, hemodynamic parameters, recovery time, and adverse effects of propofol versus etomidate in ECT.

Main Methods:

• A prospective, double-blind, randomized, controlled study involving 70 patients aged 18-65 years.
• Patients were randomly assigned to receive either propofol (1.0 mg/kg) or etomidate (0.2 mg/kg) as an intravenous induction agent.
• Motor seizure duration, induction time, hemodynamics, and recovery parameters were assessed intraoperatively and post-procedure.

Main Results:

• Etomidate resulted in significantly longer mean motor seizure duration (55.17 ± 19.06 s) compared to propofol (27.80 ± 17.33 s) (P < 0.001).
• Propofol induction led to a significant increase in heart rate (P = 0.016) and a significant decrease in mean arterial pressure (P = 0.005) compared to etomidate.
• Etomidate demonstrated more stable hemodynamic parameters during the procedure.

Conclusions:

• Etomidate offers the advantage of prolonged seizure duration and stable hemodynamics in ECT.
• Etomidate can be a valuable alternative anesthetic for ECT, particularly for patients with suboptimal therapeutic responses or insufficient seizure duration.