Anestesia e Pesquisa Clínica
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Abstrato

Comparision of Etomidate and Propofol for Motor Seizure Duration during Modified Electroconvulsive Therapy

Yasmina Mansuri*, Jaydev Dave

Background: Earlier electroconvulsive therapy was performed without any muscle relaxant so the patient required physical restraining during the seizure and experienced severe muscle pain after the procedure. To prevent myalgia and musculoskeletal complications (eg: Bone fractures or dislocations), muscle relaxants are often administered during ECT procedures. ECT with Anaesthesia and Muscle Relaxants is called Modified ECT. The type of anaesthetic agent may have a significant impact on efficacy of the treatment. The aim is to provide a short duration of unconsciousness and adequate muscle relaxation with rapid and complete return of cognitive function. Propofol has shorter induction time and rapid and smooth recovery while Etomidate has longer seizure duration and stable haemodynamics. In this study we compare Etomidate and Propofol for motor seizure duration and haemodynamic stability during electroconvulsive therapy.

Objective: A type of prospective Double blind Randomised controlled trial carried out at tertiary care unit during 2020- 2021 with 60 adult patients, after taking approval of Institutional Ethical Committee(Ref no. IEC/Certi/03/01/2021) and written informed consent in their own language according to institutional protocols and explaining the cause, pathology and consequences of the process.

Materials and methods: In this Prospective, Randomized controlled study on 60 patients of 18 to 65 years and either sex after matched inclusion criteria with American society of Anaesthesiologists class I, II and III, who were undergo modified electroconvulsive therapy Patients are divided in to two groups, Group P (n=30) and group E (n=30) in which electroconvulsive therapy was carried out using Propofol 1.5 mg/kg and Etomidate 0.2 mg/kg respectively. Motor seizure duration and haemodynamic Parameters were measured at different time interval. Statistical analysis was done by using SPSS Statistical Software version 24.0. Mean and standard deviation were calculated. Unpaired ‘t’ test were applied between Group P and Group E. p value of <0.05 is considered statistically Significant and p value<0.001 was considered statistically highly significant.

Results: Mean Motor seizure duration was longer with Etomidate (42.73 ± 9.19) as compared to Propofol (32.36 ± 6.01) and the difference was statistically highly significant (P<0.001) there was less changes in haemodynamic parameters with etomidate as compared with propofol.

Conclusion: Etomidate has longer seizure duration and stable haemodynamics compared to propofol during modified electroconvulsive therapy. It can be useful when seizures are too short and sub therapeutic inspite of maximum stimuli.