ABSTRACT
Electroconvulsive therapy (ECT) is a standard procedure in the modern psychiatric armamentarium. It involves, application of electric stimulus for a brief time in psychiatric patients to induce generalized seizure. ECT is utilized for treating various severe, treatment-resistant or refractory psychiatric disorders, schizophrenia and major depressive disorder (MDD). During ECT, severe disturbances can be noted in the cerebrovascular and cardiovascular system. Various anaesthetic drugs used in modified ECT can prevent these disturbances. We wanted to compare induction time, alteration of hemodynamics, seizure duration, and recovery time by using intravenous etomidate and intravenous propofol for induction of anaesthesia in modified electroconvulsive therapy.METHODSSixty patients were included in this prospective and comparative study. Patients of age group of 18–60 years of either sex, who had been posted for ECT therapy were randomly divided into two groups. Group E received Inj. Etomidate at 0.2 mg/Kg IV and Group P received Inj. Propofol 1% at 1.5 mg/Kg for induction of anaesthesia. Patients were monitored for various haemodynamic parameters such as heart rate, blood pressure at basal, after induction, and 1 min, 2 min, 3 min, 5 min, 10 min and 20 min following ECT. Induction time, seizure duration, quality of anaesthesia and recovery time from anaesthesia were also noted.RESULTSInduction of anaesthesia is faster with propofol (40.30 ± 3.65 sec) than with etomidate (48.63 ± 3.29 sec). Longer seizure duration was found with etomidate (58.90 ± 11.91 sec) induction in comparison to propofol (22.16 ± 5.48 sec) induction. Propofol group had more stable hemodynamic parameters compared to etomidate group following ECT. Propofol group (7 ± 1.43 min) achieved consciousness earlier than those of etomidate group (8.60 ± 1.16 min) following induction.CONCLUSIONSPropofol had the advantage of smooth induction, stable hemodynamic parameters, and rapid recovery as compared to etomidate. However, it was associated with shorter seizure duration. Etomidate had longer seizure duration which results in better clinical outcomes over propofol. However, it was associated with greater incidence of myoclonic jerks during induction.