Comparison of Propofol, Etomidate, and Thiopental in Anesthesia for Electroconvulsive Therapy

Canbek, Özge; İpekçioğlu, Derya; Menges, Okan Oktay; Atagün, Murat İlhan; Karamustafalıoğlu, Nesrin; Cetinkaya, Ozlem Zekiye; İlnem, Mehmet Cem

doi:10.1097/yct.0000000000000190

Cited by 46 publications

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“…in which mean motor seizure duration was significantly longer in etomidate as compared to propofol group ( P < 0.05). [ 10 11 ] Our results are also similar to a study done by Gazdag et al . in which propofol (1 mg.kg −1 ) and etomidate (0.2 mg.kg −1 ) were compared during the ECT of patients with schizophrenia based on their impact on seizure activity and seizure-induced hemodynamic reactions.…”

Section: Discussionsupporting

confidence: 92%

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Etomidate versus propofol for motor seizure duration during modified electroconvulsive therapy

et al. 2020

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Background: Certain anesthetic agents on account of their anticonvulsant property have a negative impact on motor seizure duration. Etomidate and propofol being devoid of the strong anticonvulsant property may be beneficial for use in electroconvulsive therapy (ECT). ECT requires sedation with a short-term anesthetic agent that does not interfere with seizure activity and has rapid onset and recovery to facilitate fast-tracking. Aims: The primary objective of this study was to compare motor seizure duration, and the secondary objective was to compare induction time, hemodynamic parameters, recovery time, and adverse effects between propofol and etomidate in modified ECT. Settings and Design: This is a prospective, double- blind, randomized, controlled study conducted in the Department of Anesthesia and Intensive care in a tertiary care hospital during 2018-2019. Materials and Methods: After ethical clearance from institutional ethics committee and written informed consent, a total of 70 patients, aged 18–65 years were randomly allocated using computer generated random number list into two groups - Group A - Propofol (1%) - 1.0 mg.kg −1 and Group B - Etomidate 0.2 mg.kg −1 as an intravenous induction agent. Intraoperatively, motor seizure duration, induction time, and hemodynamic parameters and at the end of procedure recovery parameters were assessed. Statistical Analysis Used: Data were described in terms of number (%) and mean ± standard deviation. Comparison of quantitative variables between the study groups was done using Student t -test and Mann Whitney U test for parametric and nonparametric variables respectively. For comparing categorical data, Chi -square (χ2) test was performed. Results: Mean motor seizure duration with etomidate (55.17 ± 19.06 s) was longer as compared to propofol (27.80 ± 17.33 s), and the difference was highly significant ( P < 0.001). Among hemodynamic parameters, there was a significant increase in heart rate ( P = 0.016) and significant fall in mean arterial pressure ( P = 0.005) after induction with propofol as compared to etomidate. Conclusion: Etomidate has the advantage of longer seizure duration and stable hemodynamics. It can be a useful alternative in patients achieving suboptimal therapeutic responses to ECT or where seizure duration is too short.

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Section: Discussionsupporting

confidence: 92%

“…Furthermore, the meantime to spontaneous respiration was shorter with propofol as compared to etomidate. [ 8 11 ] The propofol has an onset time of 40 s and also the metabolism of propofol is rapid which occurs mainly in the liver accounting for its rapid induction and recovery. [ 18 ] Avramov et al .…”

Section: Discussionmentioning

confidence: 99%

Etomidate versus propofol for motor seizure duration during modified electroconvulsive therapy

et al. 2020

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“…In some patients with high seizure threshold, etomidate is the firstline medication and it can improve the therapeutic effects of ECT sessions. [14] In the current study, seizure duration in ECT sessions in the etomidate group was longer than sodium thiopentone. Conca et al also observed similar findings with those in our study, in their study of 13 ECT patients.…”

Section: Discussionmentioning

confidence: 80%

Comparison of Etomidate and Thiopentone Sodium as Anaesthetic Agents for Modified Electroconvulsive Therapy

Donthu¹,

Kavya²,

Subramanyam³

2017

jemds

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“…In a study conducted at Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, we see that ECTs are most frequently used in the treatment of the manic phase of bipolar disorder patients (22). In another study conducted in the same hospital, 46.9% of the inpatients over a three-year period receiving ECT treatment were diagnosed with affective disorder and 52.1% suffered from psychotic disorder (25).…”

Section: Discussionmentioning

confidence: 99%

ECT practices in a psychiatry clinic at a training and research hospital

Eroğlu¹,

Kıraz²,

Yasar³

et al. 2017

Dusunen Adam

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ECT practices in a psychiatry clinic at a training and research hospital Objective: Electroconvulsive therapy (ECT) is an effective method of somatic therapy used in the treatment of many psychiatric disorders. Studies conducted in Turkey indicate that the frequency of ECT use varies over quite a wide range (2.2-16.3%). This study aims to investigate the diagnostic distributions in patients who were treated with ECT at a psychiatric clinic of a training and research hospital. Method:The health records of inpatients treated in our clinic between the dates of Jan 1, 2007 and June 30, 2016 were evaluated retrospectively.Results: A total of 174 patients underwent ECT within the specified time period. Of the total patients, 65.5%were female (n=114) and 34.5% were male (n=60). The average total number of ECT sessions was 7.7±4.4.The average number of ECT sessions in women was 7.2±1.9, while the average number in men was 8.6±7.1 (p=0.044). The diagnostic distributions of ECT patients were unipolar depression (63.8%), bipolar depression (18.4%), psychosis (14.9%) and bipolar mania (2.9%). Conclusion:The frequency of ECT practice in our clinic was 6.13%. Our study showed that although ECT is known as an effective and reliable method, it is not applied in our clinic at the frequency that we expected.We believe that shedding light on the effectiveness of the ECT mechanism will render it less enigmatic and increase the scope and frequency of its use.

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Comparison of Propofol, Etomidate, and Thiopental in Anesthesia for Electroconvulsive Therapy

Abstract: Propofol, etomidate, and thiopental are associated with similar safety and efficacy profiles.

Cited by 46 publications

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Etomidate versus propofol for motor seizure duration during modified electroconvulsive therapy

Etomidate versus propofol for motor seizure duration during modified electroconvulsive therapy

Comparison of Etomidate and Thiopentone Sodium as Anaesthetic Agents for Modified Electroconvulsive Therapy

ECT practices in a psychiatry clinic at a training and research hospital

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