Thiopentone versus propofol-anaesthetic of choice in patients undergoing modified electroconvulsive therapy

Vigil Peter, Sumesh Mathew, Tom Thomas


Background: The use of electroconvulsive therapy (ECT) as a treatment modality has increased over the recent years. This is largely due to the use of general anaesthetics, which reduces the physical and psychological trauma associated with the procedure. We attempted to compare the hemodynamic variations and recovery characteristics, along with their effect on seizure quality in patients induced with Thiopentone /Propofol, for Modified ECT.

Methods: This was a prospective, randomised controlled study, involving 80 patients. Patients in group 1 received Thiopentone 5 mg/kg, while patients in group 2 received Propofol 1 mg/kg. The hemodynamic status and recovery status were monitored in both the groups for the first thirty minutes. Seizural duration were also recorded. Data was analysed using Students t-test and Pearson Chi-square test.

Results: The induction time as well as recovery time was found to be significantly lesser (p <0.05) in the propofol group. The hemodynamic response to was blunted and returned to baseline levels within 10-15 minutes after ECT in the propofol group, whereas it persisted even after 30 minutes in the thiopentone group. There was however, no significant difference in the duration of the seizural activity(p> 0.05).

Conclusions: The quick and smooth induction, transient changes in hemodynamics, rapid recovery profile and minimal effects on the seizure quality altogether makes Propofol the preferred anaesthetic agent in Modified ECT.


Anaesthetics, Electroconvulsive therapy, Intravenous, Propofol, Prospective studies, Thiopentone

Full Text:



Task Force on Electroconvulsive therapy: Recommendations for treatment, training and privileging - Washington DC: American Psychiatric Association; 2001.

Cerletti U, Bini L. Electroshock article. Acad Med. 1938;64:136.

Chanpattana W. The origins of electroconvulsive therapy. J Psychiatr Assoc Thailand. 2000;45:371-80.

Shah PJ, Dubey KP, Watti C, Lalwani J. Effectiveness of thiopentone, propofol and midazolam as an ideal intravenous anaesthetic agent for modified electroconvulsive therapy: A comparative study. Indian J Anaesth. 2010;54(4):296-301.

Office of Mental Health. Electroconvulsive therapy: Clinical indications. New York state, 2007

Chittaranjan A, Shah N, Tharyan P, Reddy MS, Thirunavukarasu M, Kallivayalil RA, Nagpal R, Bohra NK, Sharma A, Mohandas E. Position statement and guidelines on unmodified ECT. Indian J Psychiatry. 2012;54(2):119-33.

Rao SS, Daly JW, Sewell DD. Falls associated with ECT among the geriatric population-a case report. JECT. 2008;24:173-5.

Arya A, Singh M, Gurwara AK. A comparison of thiopentone sodium, propofol and midazolam for electroconvulsive therapy. J Anaesthesiol Clin Pharmacol. 2008;24:291-4.

Omprakash TM, Ali MI, Anand B, Devi MG, Surender P. Comparison of thiopentone sodium and propofol in ECT anaesthesia. Indian J Psycho Med. 2008;30:48-50.

Hoyer C, Kranaster L, Janke C, Sartorius A. Impact of the anaesthetic agents ketamine, etomidate, thiopental and propofol on seizure parameters and seizure quality in electroconvulsive therapy: a retrospective study. European Archives Psychiatry Clinical Neuroscience. 2014;264(3):255.

Bolaji B, Omosofe F, Kolawole I, Makanjuola A. Comparative Effects of the haemodynamic responses of modified versus unmodified electroconvulsive therapy in Nigerians. Internet J Anaesthesiology. 2012;30(3):4169.