A comparative study of etomidate versus thiopentone for modified electroconvulsive therapy

Anesthesia during modified electroconvulsive therapy(MECT) is a complex procedure due to the goal of exciting the brain into a seizure immediately after sedation has been induced. The practice varies in centers worldwide and the optimal method for  MECT related anesthesia still remains unclear. Thiopentone and Etomidate are two commonly used agents for MECT. Thiopentone a short acting barbiturate has been a longstanding choice for MECT due to it’s rapid onset and short duration of action, however it may cause dose dependent decrease in systemic vascular resistance, stroke volume and cardiac output leading to compensatory tachycardia making it unsuitable for patients with hemodynamic instability. Etomidate a non-barbiturate hypnotic has emerged as a potential alternative to thiopentone. It exhibits rapid onset , short duration of action and hemodynamic stability during the procedure. Etomidate possesses a favorable side effect profile making it suitable for patients with comorbidities or sensitivity to certain drugs.

Thiopentone and Etomidate are commonly used anesthetics for MECT, however there is a lack of consensus on which anesthetic is most appropriate for the procedure in terms of safety, efficacy and patient outcomes. Therefore the aim of the study is to compare the efficacy and safety of Thiopentone and Etomidate for MECT.