Forty-one RCTs were included in the review (n=1,134 patients): 31 cross-over design and 10 parallel design trials. Sample sizes of included trials ranged from seven to 58 patients. Trial quality was variable: 22 trials masked investigators and subjects; 10 trials reported the method of randomisation and only four trials adequately concealed allocation; and 20 trials adequately reported data.
Motor seizure duration: Mean seizure duration was significantly longer in the methohexital group compared with the propofol group (WMD 9.06 seconds, 95% CI 5.72 to 12.40; 11 trials). There was evidence of statistical heterogeneity (I2=79%). Mean seizure duration was not statistically different for methohexital compared with methohexital-remifentanil (three trials). When propofol was compared with etomidate, mean seizure duration was significantly longer in the etomidate group (WMD 9.50 seconds, 95% CI 2.41 to16.60; three trials). There was evidence of statistical heterogeneity (I2=66%) for this comparison. When propofol was compared with propofol-alfentanil, mean seizure duration was significantly longer in the propofol-alfentanil group (WMD 12.57 seconds, 95% CI 8.63 to16.51; three trials). There was evidence of statistical heterogeneity (I2=34%) for this comparison.
EEG seizure duration: Mean EEG seizure duration was significantly longer in the methohexital group compared with the propofol group (WMD 14.82 seconds, 95% CI 9.97 to 19.67; seven trials). There was evidence of statistical heterogeneity (I2=79%) for this comparison.
Emergence Time: Mean emergence time was not significantly different in the methohexital group compared with the propofol group (eight trials). There was evidence of statistical heterogeneity (I2=79.6%). When thiopental was compared with propofol, mean emergence time was significantly shorter in the propofol group (WMD 1.75 minutes, 95% CI 1.18 to 2.32; three trials). There was no evidence of statistical heterogeneity (I2=0%) for this comparison.
Recovery Time: Mean recovery time was not significantly different in the methohexital group compared with the propofol group (five trials). There was evidence of statistical heterogeneity (I2=64%). When propofol was compared with propofol-alfentanil, mean recovery time was not significantly different in the propofol group (three trials). There was evidence of statistical heterogeneity (I2=86%) for this comparison.
Further results were reported in the paper.