Key result
Ketamine significantly prolonged motor and electroencephalogram seizure duration compared to propofol during modified ECT (P<0.001).
Why the study?
To investigate the effects of propofol and ketamine on seizure duration, hemodynamics, and recovery during electroconvulsive therapy.
Does propofol compared to ketamine affect seizure duration, hemodynamics, and recovery in patients undergoing electroconvulsive therapy?
RCT (n=44)
Does propofol compared to ketamine affect seizure duration, hemodynamics, and recovery in patients undergoing electroconvulsive therapy?
p-value: p=<0.001
Ketamine provides a longer seizure duration than propofol during ECT without causing hemodynamic instability or significant complications.
Supports ketamine over propofol for longer ECT seizures; extends RCT data on anesthetic effects on duration and hemodynamics.
Objective: To investigate the effects of propofol and ketamine on seizure duration, hemodynamics, and recovery of electroconvulsive therapy (ECT). Methods: This prospective randomized trial included patients who had undergone ECT under anesthesia. Patients received injection of propofol 1.5 mg/kg i.v . (the propofol group) or ketamine 0.8-1.2 mg/kg i.v . (the ketamine group) during ECT. Seizure duration, hemodynamics, and recovery were recorded and compared between the two groups. Results: This trial included 44 patinets with 22 patients receiving propofol and 22 patients receiving ketamine. The total dose of propofol and ketamine was (105.68±25.27) mg and (81.36±24.55) mg, respectively. The motor seizure and electroencephalogram seizure duration were prolonged in the ketamine group ( P <0.001). The hemodynamics at the admission of the two groups were comparable ( P >0.05); however, the mean systolic blood pressure during the procedure was significantly higher in the ketamine group ( P =0.04). Besides, spontaneous eye-opening in the ketamine group took longer than that of the propofol group ( P =0.001). Conclusion: Both propofol and ketamine are safe as anesthetic agents for modified ECT, and ketamine provides a longer seizure duration without hemodynamic instability or any significant complication.
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Guha et al. (2022) conducted an RCT in Electroconvulsive therapy (ECT) (n=44). Propofol vs. Ketamine (0.8-1.2 mg/kg i.v.) was evaluated on Seizure duration (p=<0.001). Ketamine significantly prolonged motor and electroencephalogram seizure duration compared to propofol during modified ECT (P<0.001).
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