By Shigeru Saito
In this publication, famous anesthesiology specialists current the newest findings on anesthesia for electro-convulsive treatment (ECT). With the improvement of converted electroconvulsive remedy (m-ECT) and units to supply brief-pulse stimulation, ECT is at present being re-evaluated as a huge approach in psychiatric illness treatment and is more and more getting used around the world to regard numerous psychiatric stipulations. This development is because of the social phenomenon of the turning out to be variety of sufferers for whom ECT is acceptable. because the new technique is extra secure and potent than the unique technique with out anesthesia, m-ECT is presently utilized below normal anesthesia in so much complex international locations. This e-book offers an outline and perform of overall anesthesia administration within the perioperative interval of ECT. It bargains an essential source not just for pro anesthesiologists but additionally healthcare pros who use this therapy.
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Additional info for Anesthesia Management for Electroconvulsive Therapy: Practical Techniques and Physiological Background
Anesthesiology. 2000;92(3):727–38. 4. Kern SE, Xie G, White JL, Egan TD. A response surface analysis of propofol–remifentanil pharmacodynamic interaction in volunteers. Anesthesiology. 2004;100(6):1373–81. 5. Johnson KB, Syroid ND, Gupta DK, Manyam SC, Egan TD, Huntington J et al. An evaluation of remifentanil propofol response surfaces for loss of responsiveness, loss of response to surrogates of painful stimuli and laryngoscopy in patients undergoing elective surgery. Anesth Analg. 2008;106(2):471–9, table of contents.
In an attempt to minimize the adverse effects of methohexital on shortening of ECT-induced seizures, Gurmarnik et al.  showed that divided doses of methohexital could minimize its adverse effects on seizure activity and improve outcomes after ECT. 3 Etomidate Anesthetic Dose (mg/kg) Fig. 1 Duration of motor and EEG seizures in patients receiving propofol, methohexital and etomidate (Avramov et al. 2 Barbiturates Barbiturates (thiopental and thiamylal) are alternatives to methohexital for anesthesia during ECT, although these drugs are associated with relatively short duration ECT seizures [10, 11].
For this reason, past studies involving respiratory management by manual mask ventilation during ECT have reported that continuous transcutaneous monitoring of pCO2 (TcPCO2) is a more useful indicator of ventilatory status . 5 Advantages of Our Practical Procedure of Respiratory Management We recommend confirming that EtCO2 tension is maintained at 30–34 mmHg with the ventilator management before attempting ES, while observing capnography after inserting proper airway devices (LMA or endotracheal intubation) under sufficient total depth of anesthesia.