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

Table 5 Cognitive outcomes by anesthetic agent

Ref.	Cognitive assessment tool	Propofol	Etomidate	Ketamine	P value
Zhong et al[14], 2016	MMSE, TMT-A, TMT-B	-	-	Dose-dependent improvement	< 0.05
Bernardoff et al[15], 2026	MoCA, RBANS	Moderate impairment	Mild impairment	-	< 0.05
Krystal et al[16], 2003	MMSE, orientation	-	-	Less impairment	< 0.01
Kavakbasi et al[24], 2023	MMSE, clock drawing	Moderate impairment	Mild impairment	-	< 0.05
Yang et al[8], 2025	MoCA, RBANS	Variable	-	-	NS
Guha et al[19], 2022	MMSE	Moderate impairment	-	Mild impairment	< 0.05

Individual study recovery times: Propofol: Consistently shorter recovery times across studies (range: 6.2-10.4 minutes). Etomidate: Moderate recovery times (range: 10.1-14.7 minutes). Ketamine: Longer recovery times (range: 13.2-18.2 minutes). Ketofol: Intermediate recovery times (range: 8.1-12.3 minutes). MMSE: Mini-Mental State Examination; TMT-A: Trail Making Test - Part A; MoCA: Montreal Cognitive Assessment; RBANS: Repeatable Battery for the Assessment of Neuropsychological Status; NS: Not significant.