Compared effects of etomidate and propofol for anaesthesia during electroconvulsive therapy

Objective Electroconvulsive therapy (ECT) requires repeated short-term anaesthesia with muscle relaxation and deep narcosis and uses several anaesthetic agents. The aim of this study was to assess the quality of the anaesthetic technique applied for ECT by comparing two products: propofol and etomidate. Methods This was a prospective randomised study that included ECT sessions. Patients were distributed into two groups. Patients of Group 1 underwent general anaesthesia with propofol (1.5mg.kg(-1)) and succinylcholine (0.75mg.kg(-1)). Patients of Group 2 were administered etomidate (0.15mg.kg(-1)) and succinylcholine (0.75mg.kg(-1)). None of the patients included had any absolute or relative contraindication to ECT. Results 104 sessions were included, with 52 sessions per group. Group 1 was composed of 12 patients and Group 2 of 13. The demographical characteristics and indication for ECT were comparable in the two groups. There was no haemodynamic variation (notably drop in blood pressure) between the groups. The duration of seizures was significantly more prolonged in the etomidate group (28.76 +/- 3.29 seconds) than in the propofol group (23.84 +/- 7.18 seconds), with significant difference (p=0.000018). Awakening was calm in both groups. Conclusion The pharmacological properties of propofol and etomidate reply precisely to the requirements of anaesthesia for ECT. Nevertheless, no drop in blood pressure was observed with the greater prolongation of seizures in the etomidate group compared with the propofol group. (c) 2005, Masson, Paris.