COMPARISON OF ETOMIDATE AND PROPOFOL AS INDUCTION AGENTS IN MODIFIED ELECTROCONVULSIVE THERAPY

Authors

  • TEJASVINI SHARMA Department of Anaesthesiology, SHRI Guru Ram RAI Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
  • ROBINA MAKKER Department of Anaesthesiology, SHRI Guru Ram RAI Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
  • PRITISH RANJAN Department of Anaesthesiology, SHRI Guru Ram RAI Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
  • TENZIN KYIZOM Department of Anaesthesiology, SHRI Guru Ram RAI Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
  • SHOBIT GARG Department of Psychiatry, SHRI Guru Ram RAI Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i3.46284

Keywords:

Electroconvulsive therapy, Cerebral hemispheres, Seizure, Etomidate, Propofol

Abstract

Objective: The aim of the study was to compare the effects of induction agents Propofol and Etomidate on hemodynamic parameters (Heart rate, Systolic Blood Pressure, Diastolic Blood pressure, and mean arterial pressure) in modified electroconvulsive therapy (ECT).

Methods: It was a prospective, randomized, and double-blinded study. The present study was conducted in the Department of Anaesthesiology at our tertiary care multispeciality referral hospital, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun. A total of 80 adult patients in the age group 20–50 years belonging to American Society of Anesthesiologists physical status I and II were included in the study. They were randomly allocated to Group I (Propofol) and Group II (Etomidate), with 40 patients in each group. The duration of the study was September 2018–February 2020.

Results: Both Etomidate and Propofol have been proposed as good induction agents to be used for ECT, but each has its own merits and demerits. Propofol leads to a significantly shorter seizure duration as compared to Etomidate. Propofol has the advantage of having rapid and smooth recovery as compared to Etomidate. Recovery criteria in terms of return to spontaneous respiration, consciousness, and fully responding were statistically significant between the two drug groups (p<0.001).

Conclusion: Propofol has the advantage of having rapid and smooth recovery as compared to Etomidate. Minimum side effects were seen in both groups. Subseizure was seen with the Propofol group more than Etomidate. Hence, we conclude that Etomidate is a better induction agent as compared to Propofol in modified ECT.

Downloads

Download data is not yet available.

References

Cerletti U, Bini L. Un Nuovo Metodo di Shockterapie: ‘l’ Elettroshock’ (Riassunto). Rome: Reale Accademia Medica (Communicazione Alla Seduta del 28 Maggio 1938-XVI della Reale Accademia Medica di Roma.); 1938.

Kadiyala PK, Kadiyala LD. Anesthesia for electroconvulsive therapy: An overview with an update on its role in potentiating electroconvulsive therapy. Indian J Anaesth 2017;61:373-80. PMCID: PMC5444214, DOI: 10.4103/ija.IJA_132_17

Scott AI. The ECT Handbook. The Third Report of the Royal College of Psychiatrists’ Special Committee on ECT. 2nd ed. London: Royal College of Psychiatrists; 2008. p. 7-26. https://doi. org/10.1177/0269881107083819

Uppal V, Dourish J, Macfarlane A. Anaesthesia for electroconvulsive therapy. Contin Educ Anaesth Crit Care Pain 2010;10:192-6.

Ross L. Electroconvulsive therapy. In: Urman R, Gross WL, Philip BK, editors. Anesthesia Outside of the Operating Room. 1st ed. New York: Oxford University Press; 2011. p. 251-9.

Aggarwal S, Goyal VK, Chaturvedi SK, Mathur V, Baj B, Kumar A. A comparative study between propofol and etomidate in patients under general anesthesia. Braz J Anesthesiol 2016;66:237-41. http://dx.doi. org/10.1016/j.bjane.2014.10.005

Erdil F, Demirbilek S, Begec Z, Ozturk E, Ersoy MO. Effects of propofol or etomidate on QT interval during electroconvulsive therapy. J ECT 2009;25:174-7. DOI: 10.1097/YCT.0b013e3181903fa5

Gazdag G, Kocsis N, Lipcsey A. Rates of electroconvulsive therapy use in Hungary in 2002. J ECT 2004;20:42-4.

Swaim JC, Mansour M, Wydo SM, Moore JL. A retrospective comparison of anesthetic agents in electroconvulsive therapy. J ECT 2006;22:243-6. DOI: 10.1097/01.yct.0000244238.17791.a4

Bauer J, Hageman I, Dam H, Báez A, Bolwig T, Roed J, et al. Comparison of propofol and thiopental as anesthetic agents for electroconvulsive therapy: A randomized, blinded comparison of seizure duration, stimulus charge, clinical effect, and cognitive side effects. J ECT 2009;25:85-90.

Jindal S, Sidhu GK, Kumari S, Kamboj P, Chauhan R. Etomidate versus propofol for motor seizure duration during modified electroconvulsive therapy. Anesth Essays Res 2020;14:62-7. DOI: 10.4103/aer.AER_5_20

Published

07-03-2023

How to Cite

SHARMA, T., R. MAKKER, P. RANJAN, T. KYIZOM, and S. GARG. “COMPARISON OF ETOMIDATE AND PROPOFOL AS INDUCTION AGENTS IN MODIFIED ELECTROCONVULSIVE THERAPY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 3, Mar. 2023, pp. 57-61, doi:10.22159/ajpcr.2023.v16i3.46284.

Issue

Section

Original Article(s)