The choice of
anesthetic for electroconvulsive therapy is based on the
anesthetic requirements to be met and on the agent's impact on the seizure threshold. Thus, the non-
barbiturate anesthesia etomidate revealed properties to enhance the seizure duration. Even though precisely this feature makes
etomidate so valuable, little research has been done on the use of
etomidate in ECT. The aim of the present study was to compare the
barbiturate anesthesia thiopentone with
etomidate, with the focus of attention being the quality of seizure. In 13 patients, the paradigm of a single intra-individual crossover
anesthesia during maintenance ECT was selected. The excitatory effects and the electroencephalographic changes were described. Furthermore, significant differences in
motor seizure duration (26.69 sec +/- 9.7 vs. 35.92 sec +/- 9.2; p < 0.007) and EEG seizure duration (39 sec +/- 14.1 sec vs. 61 sec +/- 22.2 sec; p < 0.0009) were observed. Our results confirm previous findings and reveal that after
etomidate the quality of seizure can be improved not only in terms of duration. The growing knowledge of the mode of action of
anesthetics/
hypnotics from an anesthesiological point of view and the better understanding of subcortical and cortical mechanisms, with particular consideration of the
motor seizure threshold, facilitate a differentiated choice of the
narcotic and the optimization of short
anesthesia in the course of electroconvulsive therapy.