Key result
Etomidate significantly prolonged motor seizure duration compared to propofol (37.60 vs 22.83 seconds, p=0.009) but resulted in higher mean blood pressure and heart rate during and immediately after electroconvulsive therapy.
Why the study?
Previous studies comparing the hemodynamic effects of propofol and etomidate during electroconvulsive therapy yielded ambiguous results and were limited by small sample sizes or retrospective designs.
Does etomidate compared to propofol affect hemodynamics and motor seizure duration in patients undergoing modified electroconvulsive therapy?
Population
30 patients aged 18 to 65 years with ASA physical status I and II requiring bilateral ECT
Comparison
Etomidate vs propofol for successive ECT sessions
Design
Prospective randomized crossover study
Authors
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Propofol offers superior hemodynamic stability in ECT; extends RCT evidence on anesthetic trade-offs with seizure duration.
RCT (n=30)
Double-blind
Computer random number generator with random permuted blocks
No
Does etomidate compared to propofol affect hemodynamics and motor seizure duration in patients undergoing modified electroconvulsive therapy?
Absolute Event Rate: 37.6% vs 22.83%
p-value: p=0.009
While propofol provides better hemodynamic stability during electroconvulsive therapy, etomidate significantly prolongs motor seizure duration, potentially enhancing therapeutic efficacy.
Mehta et al. (2022) conducted an RCT in Mental disorders requiring bilateral electroconvulsive therapy (n=30). Etomidate vs. Propofol (1 mg/kg IV) was evaluated on Motor seizure duration (seconds) (p=0.009). Etomidate significantly prolonged motor seizure duration compared to propofol (37.60 vs 22.83 seconds, p=0.009) but resulted in higher mean blood pressure and heart rate during and immediately after electroconvulsive therapy.
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