Efficacy of propofol versus ketamine in modified electroconvulsive therapy: A prospective randomized control trial

Abstract

Objective: To investigate the effects of propofol and ketamine on seizure duration, hemodynamics, and recovery of electroconvulsive therapy (ECT).Methods: This prospective randomized trial included patients who had undergone ECT under anesthesia. Patients received injection of propofol 1.5 mg/kg i.v. (the propofol group) or ketamine 0.8-1.2 mg/kg i.v. (the ketamine group) during ECT. Seizure duration, hemodynamics, and recovery were recorded and compared between the two groups.Results: This trial included 44 patinets with 22 patients receiving propofol and 22 patients receiving ketamine. The total dose of propofol and ketamine was (105.68±25.27) mg and (81.36±24.55) mg, respectively. The motor seizure and electroencephalogram seizure duration were prolonged in the ketamine group (P<0.001). The hemodynamics at the admission of the two groups were comparable (P>0.05); however, the mean systolic blood pressure during the procedure was significantly higher in the ketamine group (P=0.04). Besides, spontaneous eye-opening in the ketamine group took longer than that of the propofol group (P=0.001).Conclusion: Both propofol and ketamine are safe as anesthetic agents for modified ECT, and ketamine provides a longer seizure duration without hemodynamic instability or any significant complication.