Korean J Biol Psychiatry.  2017 Aug;24(3):110-128. 10.0000/kjbp.2017.24.3.110.

Practical Considerations in Anesthesia for Electroconvulsive Therapy

• Youn T
• Kim YS
• Lee NY
• Kim SH
• Choi JG
• Lee JH
• Chung IW

• KMID: 2396545
• DOI: http://doi.org/10.0000/kjbp.2017.24.3.110

Abstract

Electroconvulsive therapy (ECT) has been recognized effective as primary or secondary treatments for major psychiatric disorders including depression and schizophrenia, as well as psychiatric emergency such as suicide, food refusal and catatonia, and so on. Medicines used in anesthetic induction for ECT, cause various reactions in autonomous, hemodynamic, and neuromuscular systems. The anesthetics also affect the duration, threshold, and intensity of seizures evoked with electric stimuli, and thus modify the seizure quality in ECT. Individual characteristics of age, sex, weight, comorbid physical disorders, and medications should also be considered for optimal clinical response after ECT. When preparing for anesthesia, adequate anesthetic agents and muscle relaxants, and rapid recovery should be carefully considered. We conducted a case-series study to address practical issues that are frequently encountered during ECT anesthesia with reviews of updated journals in order to provide practical helps to clinicians who are preparing ECT for their patients.

Keyword

Electroconvulsive therapy; Anesthesia; Optimization; Major psychiatric disorders

MeSH Terms

Anesthesia*
Anesthetics
Catatonia
Depression
Electroconvulsive Therapy*
Emergencies
Hemodynamics
Humans
Schizophrenia
Seizures
Suicide
Anesthetics