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Neuro > Apex- ECT > Flashcards

Apex- ECT Flashcards

1
Q

Choose the statement that BEST describes the anesthetic considerations for the patient undergoing ECT:

A. There is an initial increase in SNS tone followed by an increase in PNS tone
B. Hypocarbia increases the seizure duration
C. Pregnancy is an absolute contraindication
D. Lithium shortens the duration of SUX

A

B. Hypocarbia increases seizure duration

making it a useful tool before ECT procedure

*there is an initial surge in PNS activity > SNS activity
*Pregnancy is a relatie contraindication (not absolute)
*Lithium prolongs (not reduces) the DOA of both Sux and nondepolarizng NMBs

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2
Q

T/f: lithium reduces hte duration nof both sux AND non-depolarizeres

A

False - prolongs DOA

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3
Q

Increase (PNS/SNS) activity during the (tonic/clonic) phase

how long does each phase last?

A

increae PNS during tonic phase (15 sec)
increased SNS during clonic phase (several minutes)

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4
Q

Absolute or Relative (A or R) contraindication to ECT:

Unstable C-Spine

A

Absolute

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5
Q

Absolute or Relative (A or R) contraindication to ECT:
Prenancy

A

Relative

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6
Q

Absolute or Relative (A or R) contraindication to ECT:
Pheo

A

Absolute

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7
Q

Absolute or Relative (A or R) contraindication to ECT:
Brain tumor

A

Absolute

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8
Q

Absolute or Relative (A or R) contraindication to ECT:
MI

what time frame

A

Absolute

past 4-6 months

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9
Q

Absolute or Relative (A or R) contraindication to ECT:
Pacer/ICD

A

Relative

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10
Q

Absolute or Relative (A or R) contraindication to ECT:

CHF

A

relative

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11
Q

Absolute or Relative (A or R) contraindication to ECT:

Glaucoma

A

relative

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12
Q

What is the efficacy of ECT primarily dependent on?

what should it be?

A

Seizure duration

> 25 seconds

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13
Q

(Hyper/hypoventilation) during induction can produce a better quality seizure

A

hyperventilation

lower co2

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14
Q

What is the gold standard induction agent for ECT

A

Methohexital

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15
Q

Absolute or Relative (A or R) contraindication to ECT:

Recent itnracranial survery

time frame

A

absolute

<3 months

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16
Q

Absolute or Relative (A or R) contraindication to ECT:
recent stroke

time frame

A

absolute

<3 months

*both intracrainial surgery and stroke < 3 months, MI < 4–6mo

17
Q

Absolute or Relative (A or R) contraindication to ECT:
Severe pulmonary disease

A

Relative

18
Q

Absolute or Relative (A or R) contraindication to ECT:
Retinal Detatchment

A

Relative

19
Q

4 Drugs that have no effect on seizure duration:

A

Methohexital, Dex, Clonidine, Esmolol

20
Q

Increase/Decreases Seizure duration:

Etomidate

A

Increases

also causes mycolonus and increaes risk of PONV and is associated with more ECT

21
Q

Increase/Decreases Seizure duration:

Alfentanyl and Fent

A

Alfent- increases
Fent - decreases

22
Q

Increase/Decreases Seizure duration:

Lidocaine

A

decreases

interesting bc i thought it lowered the siezure threshold, making it more likely to have a seizure …

23
Q

Increase/Decreases Seizure duration:
Propofol

A

decreases but blunts the hemodynamic response

24
Q

T/f: methohexital has no effect on seizure duration

A

True

Neuro (5 decks)

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