Comparison of Intravenous Etomidate and Propofol on Haemodynamic Responses and Seizure Duration during Modified Electroconvulsive Therapy: A Prospective Study

Dr. Nihar Ranjan Subudhi, Dr. Dhruti Prasad Parida

Abstract: Background: Modified electroconvulsive therapy (M-ECT) is a well-established and effective therapeutic modality for severe and treatment-resistant psychiatric disorders. The introduction of general anaesthesia and neuromuscular blockade has significantly enhanced the safety and acceptability of ECT. The choice of anaesthetic induction agent plays a crucial role in determining seizure quality, haemodynamic responses, recovery characteristics, and overall procedural safety. Among the commonly used agents, propofol and etomidate exhibit distinct pharmacological profiles that may influence clinical outcomes. Aims: To compare Etomidate and Propofol as induction agents during M-ECT with respect to seizure duration, haemodynamic responses, and recovery parameters. Study Design: Prospective, randomized, crossover comparative study. Materials and Methods: The study was conducted at Hi-Tech Medical College & Hospital, Bhubaneswar, from December 2023 to November 2025. The study included 100 ASA I and ASA II patients aged 18-60 years, scheduled for M-ECT. Patient were randomly divided into 2 group. Group P: Received Propofol (2 mg/kg) Group E: Received Etomidate (0.2 mg/kg). Patients received Etomidate and Propofol on separate treatment sessions. Seizure duration (motor), haemodynamic variables (SBP, DBP, MAP, HR), induction time, recovery time, and adverse effects were recorded at predefined intervals. Statistical analysis was performed using appropriate parametric and non-parametric tests. Results: Etomidate produced significantly longer seizure duration compared to Propofol. Propofol provided superior attenuation of the sympathetic response, with lower post-ictal increases in heart rate and blood pressure, and faster recovery. Adverse effect profiles differed, with myoclonus more common with Etomidate and hypotension and injection pain more frequent with Propofol. Discussion: The findings reflect the distinct pharmacological properties of both agents. Etomidate is advantageous when seizure adequacy is the primary concern, whereas Propofol is preferable in patients requiring tighter haemodynamic control and rapid recovery. Conclusion: Neither agent is universally ideal. Anaesthetic choice for M-ECT should be individualized, balancing seizure requirements against cardiovascular risk and recovery priorities.

Keywords: Modified Electroconvulsive Therapy; Etomidate; Propofol; Seizure Duration; Haemodynamic Response; Anaesthesia

How to Cite?: Dr. Nihar Ranjan Subudhi, Dr. Dhruti Prasad Parida, "Comparison of Intravenous Etomidate and Propofol on Haemodynamic Responses and Seizure Duration during Modified Electroconvulsive Therapy: A Prospective Study", Volume 14 Issue 12, December 2025, International Journal of Science and Research (IJSR), Pages: 1991-1994, https://www.ijsr.net/getabstract.php?paperid=SR251223233034, DOI: https://dx.doi.org/10.21275/SR251223233034