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Ect anesthesia

Rafał Wojdacz, Łukasz Święcicki, Anna Antosik-Wójcińska
Electroconvulsive therapy (ECT) is the treatment method widely used in psychiatric disorders such as depression, bipolar disorder, schizophrenia and schizoaffective disorder. The advantage of ECT is therapeutic response that occurs significantly earlier than during pharmacotherapy. Initially ECTwas used without anesthesia. Then, in the 1950s procedures with general anesthesia were introduced to reduce the complications that may occur during a seizure caused by ECT, such as broken bones, teeth, tendon rupture, muscle damage...
December 30, 2017: Psychiatria Polska
A Jorgensen, S J Christensen, A E K Jensen, N V Olsen, M B Jorgensen
BACKGROUND: Electroconvulsive therapy (ECT) continues to be the most efficacious treatment for severe depression and other life-threatening acute psychiatric conditions. Treatment efficacy is dependent upon the induced seizure quality, which may be influenced by a range of treatment related factors. Recently, the time interval from anesthesia to the electrical stimulation (ASTI) has been suggested to be an important determinant of seizure quality. METHODS: We measured ASTI in 73 ECT sessions given to 22 individual patients, and analyzed its influence on five seizure quality parameters (EEG seizure time, power, coherence, postictal suppression, and peak heart rate)...
April 15, 2018: Journal of Affective Disorders
Yael M Cycowicz, Stefan B Rowny, Bruce Luber, Sarah H Lisanby
OBJECTIVE: Evidence suggests that magnetic seizure therapy (MST) results in fewer side effects than electroconvulsive treatment, both in humans treated with electroconvulsive therapy (ECT) as well as in the animal preclinical model that uses electroconvulsive shock (ECS). Evidence suggests that MST results in fewer cognitive side effects than ECT. Although MST offers enhanced control over seizure induction and spread, little is known about how MST and ECT seizures differ. Seizure characteristics are associated with treatment effect...
December 12, 2017: Journal of ECT
Minling Zhang, Robert Rosenheck, Xiaoming Lin, Qirong Li, Yanling Zhou, Yunshan Xiao, Xiong Huang, Ni Fan, Hongbo He
BACKGROUND: Electroconvulsive therapy (ECT) is a rapid acting and effective treatment for both major depressive disorder (MDD) and bipolar disorder (BP). Both propofol and ketamine are commonly used anesthetic agents but recent clinical studies suggest that ketamine has rapid-acting antidepressant properties, itself, at sub-anesthetic doses. METHODS: A total of 77 inpatients (41 MDD and 36 BP) were randomly assigned to receive ECT with propofol (1mg/kg) anesthesia or with ketamine (0...
February 2018: Journal of Affective Disorders
Seshagiri Rao Doddi, Matthew Lotz, William T Regenold, Lawrence Adler
The safety of electroconvulsive therapy (ECT) is improving with advances in anesthesia and ECT technique. There are published case reports of successful treatment of depression in patients who were once considered at high medical risk. Recent cerebral hemorrhage is one of the conditions considered to significantly increase the risk of ECT treatment. Literature search did not indicate any case reports of ECT treatment in patients with recent subarachnoid hemorrhage. We report the successful ECT treatment of depression in an older man who had developed a subarachnoid hemorrhage after a suicide attempt by ingestion of antifreeze...
October 3, 2017: Journal of ECT
Jayme Ahmed, Michael Metrick, Anne Gilbert, Anita Glasson, Ranjeet Singh, Wayne Ambrous, Lori Brown, Laura Aykroyd, Karen Bobel
OBJECTIVES: Super refractory status epilepticus (SRSE) is a stage beyond refractory status that requires general anesthesia as management. Electroconvulsive therapy (ECT) is recommended only as a potential treatment option beyond general anesthesia and after all other options have been exhausted. Its effect on aborting status has been minimally researched. We present the largest case series to our knowledge exploring the effect of ECT on SRSE. METHODS: Eight adults hospitalized for SRSE received ECT in an attempt to abort status after other treatment modalities were exhausted...
September 20, 2017: Journal of ECT
Katarzyna Szaulińska, Anna Antosik-Wójcińska, Ewa Paszkowska, Łukasz Święcicki, Marek Jarema, Adam Wichniak
OBJECTIVES: Obstructive sleep apnea (OSA) is a common clinical problem that can have serious health consequences and complicate the course of mental disorders. It is estimated that the prevalence of sleep apnea in patients with bipolar disorder can be 21-47.5%. Some symptoms of OSA are the same as the symptoms of depression: daytime drowsiness, cognitive dysfunction, decreased drive, apathy, depressed mood, anhedonia. METHODS: We present a case of a patient whose depressive symptoms persisted despite repeated changes of pharmacological treatment and were exacerbated by severe sleep disorder...
June 18, 2017: Psychiatria Polska
Nagy A Youssef, Emad Sidhom
BACKGROUND: Current pulse amplitude used in clinical ECT may be higher than needed. Reducing pulse amplitude may improve focality of the electric field and thus cognitive adverse effects. Here we examine the feasibility, safety, and whether Low Pulse Amplitude Seizure Therapy (LAP-ST, 0.5-0.6A) minimizes cognitive adverse effects while retaining efficacy. METHODS: Patients with treatment-resistant primary mood (depressive episodes) or psychotic disorders who were clinically indicated to undergo ECT were offered to be enrolled in an open-label study...
November 2017: Journal of Affective Disorders
Sarah Kayser, Bettina H Bewernick, Martin Soehle, Christina Switala, Sabrina M Gippert, Nadine Dreimueller, Thomas E Schlaepfer
OBJECTIVES: Anesthesia is required for both magnetic seizure therapy (MST) and electroconvulsive therapy (ECT), although it has anticonvulsant properties. In this case, bispectral index (BIS) monitoring, a specific electroencephalogram-derived monitoring, can be used to find the optimal seizure induction time during anesthesia to elicit adequate seizures. A measurement of seizure adequacy in electroencephalogram is the postictal suppression. The purpose of this study was to investigate the influence of seizure induction time on the degree of postictal suppression by comparing BIS versus no-BIS monitoring in MST and ECT...
September 2017: Journal of ECT
Arnaud Leroy, Florian Naudet, Guillaume Vaiva, Andrew Francis, Pierre Thomas, Ali Amad
We aimed to review and discuss the evidence-based arguments for the efficacy of electroconvulsive therapy (ECT) in the treatment of catatonia. Randomized controlled trials (RCTs) and observational studies focusing on the response to ECT in catatonia were selected in PubMed, the Cochrane Library, Embase, and Current Controlled Trials through October 2016 and qualitatively described. Trials assessing pre-post differences using a catatonia or clinical improvement rating scale were pooled together using a random effect model...
June 21, 2017: European Archives of Psychiatry and Clinical Neuroscience
Suna Su Aksay, Jan Malte Bumb, Dmitry Remennik, Manfred Thiel, Laura Kranaster, Alexander Sartorius, Christoph Janke
OBJECTIVES: Postictal agitation (PIA) represents one of the most common complications during a modified electroconvulsive therapy (ECT) course. Its clinical management can be challenging especially in cases with poor response to benzodiazepines. Dexmedetomidine, a highly selective alpha-2 adrenoceptor agonist acting predominantly in the locus coeruleus, exerts sedative effects without causing relevant respiratory depression. To the best of our knowledge, this is the first study that aimed to assess the impact of dexmedetomidine use with S-ketamine anesthesia on PIA reduction in ECT...
2017: Neuropsychiatric Disease and Treatment
Maxim Zavorotnyy, Ina Kluge, Kathrin Ahrens, Thomas Wohltmann, Benjamin Köhnlein, Patricia Dietsche, Udo Dannlowski, Tilo Kircher, Carsten Konrad
Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0...
December 2017: European Archives of Psychiatry and Clinical Neuroscience
Shona L Ray-Griffith, Lou Ann Eads, Xiaotong Han, Kimberly Golden, Zachary N Stowe
OBJECTIVE: This randomized controlled pilot study examines the differences in response to electroconvulsive therapy (ECT) as defined by an improvement of depressive symptoms between ketamine and methohexital as the primary anesthetic agent. Adverse effects and cognitive tolerability were also examined. METHODS: Subjects undergoing ECT for unipolar or bipolar depression were randomized to receive ketamine or methohexital as the anesthetic agent. Primary outcome measure includes the Hamilton rating scale for depression (17-item)...
December 2017: Journal of ECT
N Tørring, S N Sanghani, G Petrides, C H Kellner, S D Østergaard
OBJECTIVE: Electroconvulsive therapy (ECT) remains underutilized because of fears of cognitive and medical risks, including the risk of death. In this study, we aimed to assess the mortality rate of ECT by means of a systematic review and pooled analysis. METHOD: The study was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The ECT-related mortality rate was calculated as the total number of ECT-related deaths reported in the included studies divided by the total number of ECT treatments...
May 2017: Acta Psychiatrica Scandinavica
Ahmad N AlHadi, Fahad M AlShahrani, Ali A Alshaqrawi, Mohanned A Sharefi, Saud M Almousa
OBJECTIVES: To assess the knowledge of and attitudes towards ECT among psychiatrists and family physicians in Saudi Arabia. METHODS: The study is quantitative observational cross-sectional with a convenient sample that included psychiatrists and family physicians (including residents) in Saudi Arabia. RESULTS: Of the 434 questionnaires emailed, a total of 126 returned completed questionnaires (29% response rate). The mean age of respondents was 35 years old...
2017: Annals of General Psychiatry
Xiang Li, Fang Tan, Nan Cheng, Na Guo, Zhi-Yong Zhong, Zi-Qing Hei, Qian-Qian Zhu, Shao-Li Zhou
OBJECTIVE: The aim of this study was to investigate how the combined use of dexmedetomidine with intravenous anesthetics influences seizure duration and circulatory dynamics in electroconvulsive therapy (ECT). METHODS: A literature search was performed to identify studies that evaluated the effect of dexmedetomidine on motor- or electroencephalogram (EEG)-based seizure durations and maximum mean arterial pressure (MAP) and heart rate (HR) after ECT. Moreover, recovery time and post-ECT agitation were evaluated...
September 2017: Journal of ECT
Georgia Trakada, Lemonia Velentza, Angeliki Konsta, Athanasia Pataka, Paul Zarogoulidis, Dimitris Dikeos
This is a case description of two patients with bipolar affective disorder, who presented complications, possibly due to underlying, undiagnosed obstructive sleep apnea syndrome (OSAS), during anesthesia for electroconvulsive therapy (ECT). The first patient, just after receiving the second ECT, developed tachypnea with spasm of the upper airways and severe oxygen desaturation He was intubated and transferred to the medical intensive care unit where he was extubated 15 h later. The second patient, just after the eighth ECT, developed tachycardia and severe hypertension...
2017: Respiratory Medicine Case Reports
Altaf Hussain Mir, Nida Farooq Shah, Mehraj Ud Din, Shabir Ahmad Langoo, Fayaz Ahmad Reshi
INTRODUCTION: Electroconvulsive therapy (ECT) is a well-established psychiatric treatment in which seizures are electrically induced in patients for therapeutic effects. ECT can produce severe disturbances in the cardiovascular system and a marked increase in cerebral blood flow and intracranial pressure. These cardiovascular changes may be altered using various anesthetic drugs. AIM AND OBJECTIVES: This study was undertaken to compare the effects of intravenous (IV) sodium thiopentone, propofol, and etomidate, used as IV anesthetic agents in modified ECT as regards, induction time and quality of anesthesia, alteration of hemodynamics, seizure duration, and recovery time...
January 2017: Saudi Journal of Anaesthesia
Verònica Gálvez, Colleen K Loo
The anesthetic-electroconvulsive therapy (ECT) time interval (time interval elapsed from the beginning of anesthesia injection to the beginning of ECT stimulus) has been reported to have an important impact on seizure quality outcomes, because it is an indirect measure of the anesthetic plasma concentration when the ECT electrical stimulus is administered. We report the importance of the routine monitoring of this time interval in clinical settings, as an additional measure to interpret seizure quality outcomes at each ECT session, to further assist on ECT dosing decisions during the treatment course...
March 2017: Journal of ECT
Margaret A O'Donoghue, Jeffrey Martel
BACKGROUND: Third year medical students at our institution are required to complete a one-week rotation in anesthesia as part of their required twelve week surgery clerkship. During this constrained time, our aim was to provide students with a focused and goal-oriented preview of anesthesiology which would allow students going into various fields to have an appreciation of the field. CURRICULUM DESIGN: The one-week curriculum is a combination of lecture, simulation, operating room teaching and hands on experience aimed at providing students with some fundamentals of procedural skills and a knowledge base of anesthesia...
July 2016: Journal of Education in Perioperative Medicine: JEPM
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