Assessment of Propofol and etomidate effect on the duration of convulsion and hemodynamic responses to electroconvulsive therapy

Aim and Background: Electroconvulsive therapy (ECT) is considered as the most effective treatment method for major depression and psychiatric disorders. Significant hemodynamic changes occur in patients treated with ECT and the duration of seizure after ECT is considered as an important factor in the success of this treatment method. This study aimed to compare the effect of etomidate and propofol on seizure duration and hemodynamic parameters in ECT. Methods and Materials: This study is a double blind clinical trial on 27 patients (54 patient sessions), aged 12-60 years with ASA class I-II. In the first patient session induction of anesthesia for ECT was applied by either propofol (2 mg/kg) or etomidate (0.2 mg/kg) and for the second patient session (with a time interval of 48 hours) the other drug was applied. Systolic blood pressure, diastolic blood pressure and heart rate were measured and recorded in four stages of ECT once before and then 1, 3 and 5 minutes after ECT. Seizure duration was measured in each session. Data analysis was applied by SPSS software and a P value <0.05 was considered significant. Findings: The mean age of participants in this study was 35.9 ± 10.4. The mean duration of seizure during propofol and etomidate anesthesia was 35.14 and 35.74 seconds, respectively (P = 0.240). Mean systolic and diastolic blood pressure and heart rate every time after seizure during propofol anaesthesia was less than etomidate (P =0.05). conclusions: There was no significant difference regarding seizure duration and hemodynamic changes subsequent to ECT, between propofol and etomidate anesthesia.