Comparison of Propofol, Etomidate, and Thiopental in Anesthesia for Electroconvulsive Therapy: A Randomized, Double-blind Clinical Trial

• Published in: The journal of ECT Vol. 31; no. 2; pp. 91 - 97
• Main Authors: Canbek, Ozge, Ipekcoglu, Derya, Menges, Okan Oktay, Atagun, Murat Ilhan, Karamustafaloglu, Nesrin, Cetinkaya, Ozlem Zekiye, Ilnem, Mehmet Cem
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-06-2015; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Anesthesia; Anesthesia Recovery Period; Anesthesia, Intravenous - methods; Anesthetics, Intravenous - administration & dosage; Anesthetics, Intravenous - adverse effects; Cardiovascular system; Clinical trials; Cognition - drug effects; Convulsions & seizures; Double-Blind Method; Drug Interactions; Electroconvulsive therapy; Electroconvulsive Therapy - methods; Electroencephalography; Etomidate - administration & dosage; Etomidate - adverse effects; Female; Hemodynamics - drug effects; Humans; Male; Mental Disorders - therapy; Middle Aged; Neurosurgery; Propofol - administration & dosage; Propofol - adverse effects; Seizures - physiopathology; Socioeconomic Factors; Thiopental - administration & dosage; Thiopental - adverse effects; Young Adult; Istanbul Turkey; Turkey
• ISSN: 1095-0680; 1533-4112
• DOI: 10.1097/YCT.0000000000000190

OBJECTIVESThis study aimed to compare the effects of propofol, thiopental, and etomidate, which are routinely used in anesthesia for electroconvulsive therapy (ECT), on the cardiovascular system, seizure variables, recovery, cognitive functions, and response to treatment.
METHODSMale patients hospitalized at the Seventh Psychiatry Clinics of the Bakırköy Teaching Hospital for Psychiatry, Neurology, and Neurosurgery who were treated with ECT were investigated prospectively. The effects on cardiovascular system parameters (heart rate, blood pressure, and blood oxygenation), seizure variables (duration and intensity of seizure), and recovery variables were recorded at every session, on prespecified time points, and the findings of the first session were used in this evaluation. In addition, clinical responses to treatment were evaluated with tests of cognitive functions before and after a course of ECT. Adverse effects were recorded.
RESULTSThe sociodemographic characteristics of the 3 treatment groups were similar. There were no significant differences among the groups in terms of effects on cardiovascular system variables, seizure variables, and cognitive functions. The clinical response to ECT was good in all groups, without any significant differences.
CONCLUSIONSPropofol, etomidate, and thiopental are associated with similar safety and efficacy profiles.