Propfol versus methohexital for electroconvulsive therapy - A meta-analysis

A systematic search (Medline, Cochrane library, Embase, bibliographies, to 5.2000, no language restriction) was performed for published reports of ran domized comparisons of propofol and methohexital for anesthesia during elec troconvulsive therapy. We analyzed 15 trials with data on 706 patients. The duration of motor seizure was shorter with propofol (range, 18-39 seconds) than with methohexital (range, 26-48 seconds, weighted mean difference 8.4 seconds [95% CI, 6.6-10.0]). With both propofol and methohexital, there wa s little evidence of an association between dose and duration of motor seiz ure (for propofol: r(2) = 0.25, P = .08: for methohexital: r(2) = 0.11, P = .27). Two small trials investigated clinical outcome; results were inconcl usive. Data on adverse effects were sparse. Duration of seizure was not pro ven to be a useful measure of treatment success in the study of electroronv ulsive therapy with propofol or methohexital. The impact of the technique o f anesthesia on the underlying disease needs to be established.