Is ketamine–propofol mixture (ketofol) an appropriate alternative induction agent for electroconvulsive therapy?

therefore their side-effects on these systems could be reduced by administering a combination of them at a lower dose.[9] In recent studies done on patients undergoing ECT, it showed that using sub-anesthetic ketamine and low-dose propofol could increase the seizure duration, provide hemodynamic stability and earlier recovery compared with the use of a full dose of propofol alone. In a study by Wang et al. with aim to evaluate the effects of combined anesthesia (propofol and ketamine) for patients with depressive disorder undergoing ECT, it showed that decreases in depression scores were significantly greater in ketamine and propofol plus ketamine groups compared with those in propofol group. Also the adverse effects in propofol plus ketamine group were fewer than those in ketamine group. This suggests that propofol combined with ketamine anesthesia might be the first-choice anesthesia in patients with depressive disorder undergoing ECT.[14] In another study by Yalcin et al. with aim to evaluate the effect of ketamine, propofol and ketofol (combination of ketamine and propofol) on hemodynamic profile, duration of seizure activity and recovery times in patients undergoing ECT have been shown that ketofol 1: 1 mixture is associated with longer mean seizure time than propofol and shorter mean recovery times than ketamine, with better hemodynamic stability, without any important side effects in ECT anesthesia.[4]