Induction Agents in ECT: effects on Seizure Duration, Quality, and Recovery

This prospective, randomized controlled study was designed to compare the effects ofdifferent anesthetic induction agents used during electroconvulsive therapy (ECT) onseizure characteristics, recovery profile, hemodynamic responses, anesthesia depth, andpost‐procedural complications. Adult patients scheduled to undergo ECT were randomizedinto four groups according to the induction agent administered: propofol, thiopental,ketamine, or ketofol.During each ECT session, seizure duration and postictal suppression index were recordedas indicators of seizure characteristics and seizure quality. Recovery was assessed usingthe time to reach a Modified Aldrete Score of 9. Hemodynamic parameters, includingsystolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heartrate, and peripheral oxygen saturation, were measured at predefined peri‐procedural timepoints. Patient State Index values obtained using SedLine monitoring were also recordedbefore induction, before ECT stimulation, 1 minute after stimulation, and duringrecovery.Post‐procedural complications, including agitation, pain, nausea, and vomiting, wererecorded during the recovery period after each ECT session. The study aimed to determinewhether different induction agents differ in terms of seizure duration, seizure quality,recovery time, hemodynamic stability, anesthesia depth, and recovery‐related adverseevents in patients undergoing ECT.