Aoki N, Suwa T, Kawashima H, et al. - Researchers sought to provide an up-to-date and comprehensive review on the effects of using of sevoflurane, the most commonly used inhaled anesthetic in electroconvulsive therapy (ECT), on seizure adequacy (seizure duration and postictal suppression index [PSI]) and circulatory dynamics in ECT. They conducted a meta-analysis including a total of 12 RCTs (377 patients and 1,339 ECT sessions) on this topic. Findings revealed correlation of using sevoflurane with significant reduction in seizure duration when compared with other types of anesthetics, including propofol, barbiturates and ketamine. Significantly increased post ECT heart rate was recorded in correlation with the use of sevoflurane vs intravenous anesthetics in ECT. The use of sevoflurane in ECT brings about no significant difference in the adverse event risk compared with those using intravenous anesthetics for ECT. Hence, no compelling evidence favoring sevoflurane use for ECT was gained, except in cases where intravenous access is challenging.