Impact of different anesthetic agents (propofol, etomidate, ketamine) on seizure duration and cognitive recovery in electroconvulsive therapy

Table 3 Characteristics of included studies

Ref.	Study type	n	Age (years)	Anesthetic agents	Primary outcomes	Follow-up
Shahu et al[5], 2024	RCT	60	42.3 ± 12.1	Propofol vs etomidate	Seizure duration, hemodynamics	Immediate
Zhong et al[14], 2016	RCT	90	35.2 ± 10.5	Ketamine (different doses)	Mood, neuropsychological	1 month
Erdogan Kayhan et al[22], 2012	RCT	48	44.7 ± 15.2	Ketofol vs propofol	Seizure duration, recovery	Immediate
İkiz et al[9], 2021	RCT	80	46.1 ± 13.7	Propofol vs propofol + remifentanil	Hemodynamics, seizure duration	Immediate
Jindal et al[6], 2020	RCT	60	38.9 ± 11.3	Etomidate vs propofol	Motor seizure duration	Immediate
Canbek et al[7], 2015	RCT	120	41.6 ± 14.8	Propofol vs etomidate vs thiopental	Seizure parameters, recovery	Immediate
Mathur et al[10], 2024	RCT	100	43.2 ± 12.9	Propofol vs ketofol	Seizure duration, hemodynamics	Immediate
Joshi et al[20], 2021	RCT	80	40.5 ± 13.2	Ketofol vs etomidate	Seizure duration, recovery	Immediate
Brunelin et al[18], 2020	RCT	58	47.8 ± 15.1	Propofol + ketamine vs propofol	Clinical response	6 weeks
Guha et al[19], 2022	RCT	50	39.7 ± 12.6	Propofol vs ketamine	Efficacy, cognitive function	2 weeks
Bernardoff et al[15], 2026	Observational	156	52.3 ± 16.4	Various	Cognitive function	6 months
Hoyer et al[12], 2014	Observational	1253	54.7 ± 17.2	Ketamine, etomidate, thiopental, propofol	Seizure parameters	Immediate
Krystal et al[16], 2003	Observational	89	48.2 ± 14.3	Ketamine vs methohexital	Seizure duration, cognitive	1 week
Kavakbasi et al[24], 2023	Observational	124	45.9 ± 13.8	Thiopental vs propofol	Cognitive effects, seizure	1 month
Tufek et al[13], 2014	Observational	210	47.3 ± 15.6	Various	Seizure duration, recovery	Immediate
Kök Kendirlioğlu et al[25], 2025	Observational	78	44.1 ± 12.7	Ketamine + ECT	Treatment resistance	3 months
Lundin et al[17], 2025	Observational	892	49.6 ± 16.8	Various	Treatment outcomes	17 years
Yang et al[8], 2025	Observational	186	41.2 ± 14.5	Various	Cognitive function	6 months
Gurel et al[28], 2022	Observational	120	43.8 ± 13.9	Ketofol, etomidate, propofol, thiopental	Seizure parameters	Immediate
Sartorius et al[11], 2021	Observational	234	52.1 ± 17.3	S-ketamine + propofol	Seizure quality	Immediate
Yoon et al[27], 2023	Observational	98	46.7 ± 14.2	Etomidate vs propofol	Clinical response	3 months
Methfessel et al[26], 2023	Observational	67	51.4 ± 16.1	Propofol/esketamine vs methohexital	Seizure quality	Immediate
Beyazyüz et al[23], 2023	Observational	84	42.9 ± 13.4	Propofol vs ketamine-propofol	ECT parameters	Immediate

RCT: Randomized controlled trial; ECT: Electroconvulsive therapy.