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Previous reports of a much greater incidence of arrhythmias with thiopental anesthesia for electroconvulsive therapy (ECT) compared to methohexital were reexamined and the possible role of hypercapnia reconsidered. Review of 50 treatments with each agent in 13 patients who had received each at our facility revealed only one brief episode of arrhythmia. The importance of postictal hyperventilation in preventing hypercapnia and associated arrhythmias was suggested.
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