AANA December 2023 Journal Course: Anesthetic Management of Patients Undergoing Electroconvulsive Therapy-AANA December 2023 Journal Course: Anesthetic Management of Patients Undergoing Electroconvulsive Therapy

AANA December 2023 Journal Course: Anesthetic Management of Patients Undergoing Electroconvulsive Therapy

Pdf Summary

Electroconvulsive Therapy (ECT) is a widely used psychiatric procedure for the treatment of mood disorders and other psychiatric illnesses. The anesthetic management of patients undergoing ECT requires an understanding of the procedure, the physiological changes induced by electrical stimulus, the choice of anesthetic agents, and potential complications. ECT involves passing an electric current through the brain using electrodes to induce generalized cerebral seizures. The procedure is typically performed three times per week for several sessions. The physiological response to ECT includes facial grimacing, limb extension, and rhythmic movements. Cardiovascular responses include bradycardia and hypotension followed by a sympathetic surge. ECT is used in the treatment of major depressive disorder, bipolar depression, catatonia, and other conditions. Anesthetic management during ECT involves the use of sedative/hypnotics such as methohexital or etomidate for induction, muscle relaxants to reduce the risk of injury, and adjuncts to manage cardiovascular responses and side effects. Complications of ECT can include headache, myalgia, confusion, nausea, vomiting, dental damage, postictal delirium, cognitive impairment, aspiration, pulmonary edema, cardiac arrhythmias, and status epilepticus. Special considerations for anesthetic management during ECT include pregnancy, the presence of metallic devices, and the use of newer forms of convulsive therapies such as Magnetic Seizure Therapy (MST) and Focal Electrically Administered Seizure Therapy (FEAST). An interdisciplinary approach and up-to-date knowledge are essential for optimizing treatment outcomes and patient safety during ECT.

Keywords

Electroconvulsive Therapy

ECT

psychiatric procedure

anesthetic management

physiological changes

cardiovascular responses

major depressive disorder

sedative/hypnotics

complications

interdisciplinary approach