Korean J Anesthesiol.  2006 Feb;50(2):236-239. 10.4097/kjae.2006.50.2.236.

Anesthesia for Caffeine Augmentation in Electroconvulsive Therapy: A case report

• Heo JS
• Kim GH
• Lee SM

• KMID: 2237468
• DOI: http://doi.org/10.4097/kjae.2006.50.2.236

Abstract

The efficacy of electroconvulsive therapy (ECT) in depression is dependent on the duration of seizure. Over a course of ECT, progressive reduction in the duration of the induced seizure is common. Caffeine pretreatment is reported to prolong seizure activity in patients experiencing inadequate seizure activity although maximal electrical stimulus for ECT is applied. The side effects of caffeine are anxiety, psychomotor agitation, prolonged seizures, enhanced hemodynamic changes and arrythmias. Caffeine is generally well tolerated by most patients, but it should be used with caution for those medically fragile patients, i.e., with preexisting cardiac disease. We describe here a case of anesthesia for ECT with caffeine augmentation. A 61-year-old man was diagnosed of major depression. Caffeine pretreatment with ECT was scheduled after antidepressants and 3 ECTs failed. Hypertension and tachyarrythmia were treated with esmolol.

Keyword

caffeine; electroconvulsive therapy; esmolol

MeSH Terms

Anesthesia*
Antidepressive Agents
Anxiety
Arrhythmias, Cardiac
Caffeine*
Depression
Electroconvulsive Therapy*
Heart Diseases
Hemodynamics
Humans
Hypertension
Middle Aged
Psychomotor Agitation
Seizures
Antidepressive Agents
Caffeine