Guidelines for the Adequate Initial Electric Stimuli in Bilateral ECT Using MECTA Device

Lee, Myung Byong; Ahn, Joon Ho; Lee, Chul; Han, Oh Su; Kim, Chang Yoon

Abstract

OBJECTIVE
In applying Electro-Convulsive Therapy(ECT) to patients, initial electric stimuli have been often determined without the adequate guidelines. This study was designed to determine adequate numerical value of parameters for initial electric stimuli inducing seizure successfully in ECT. We prepared Asan Medical Center(AMC) guidelines for 4 parameters based on our clinical experiences and MECTA(Monitored Electro-Convulsive Therapy Apparatus, MECTA Crop(R)) instruction manual, and investigated the success rate in the first session of ECT following AMC guidelines for parameters. METHOD: Twenty-two patients(male 10, female 12) treated with ECT using MECTA SR-1 model in Asan Medical Center between september 1996 and october 1998 were included in this study. We carried out bilateral ECT under anesthesia according to AMC guidelines. Seizure that persisted longer than 20 seconds was considered successful.
RESULTS
18 of 22 patients showed successful seizures in the first session (82%). Four patients failed to show successful seizures. One out of the foiled patients received inadequate stimuli due to premature release of switch burton and two patients were taking continuously anticonvulsants and anxiolytics, respectively prior to ECT. But all foiled patients except one, who was thought to have unusually high seizure threshold, demonstrated successful seizures in the second session with the same initial parameters.
CONCLUSIONS
The bilateral ECT according to AMC guidelines resulted in the adequate seizures in all patients except one patient who had unusually high seizure threshold. These data show that AMC guidelines can be successfully applied in ECT using MECTA device.