Apex- ECT Flashcards
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
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
T/f: lithium reduces hte duration nof both sux AND non-depolarizeres
False - prolongs DOA
Increase (PNS/SNS) activity during the (tonic/clonic) phase
how long does each phase last?
increae PNS during tonic phase (15 sec)
increased SNS during clonic phase (several minutes)
Absolute or Relative (A or R) contraindication to ECT:
Unstable C-Spine
Absolute
Absolute or Relative (A or R) contraindication to ECT:
Prenancy
Relative
Absolute or Relative (A or R) contraindication to ECT:
Pheo
Absolute
Absolute or Relative (A or R) contraindication to ECT:
Brain tumor
Absolute
Absolute or Relative (A or R) contraindication to ECT:
MI
what time frame
Absolute
past 4-6 months
Absolute or Relative (A or R) contraindication to ECT:
Pacer/ICD
Relative
Absolute or Relative (A or R) contraindication to ECT:
CHF
relative
Absolute or Relative (A or R) contraindication to ECT:
Glaucoma
relative
What is the efficacy of ECT primarily dependent on?
what should it be?
Seizure duration
> 25 seconds
(Hyper/hypoventilation) during induction can produce a better quality seizure
hyperventilation
lower co2
What is the gold standard induction agent for ECT
Methohexital
Absolute or Relative (A or R) contraindication to ECT:
Recent itnracranial survery
time frame
absolute
<3 months
Absolute or Relative (A or R) contraindication to ECT:
recent stroke
time frame
absolute
<3 months
*both intracrainial surgery and stroke < 3 months, MI < 4–6mo
Absolute or Relative (A or R) contraindication to ECT:
Severe pulmonary disease
Relative
Absolute or Relative (A or R) contraindication to ECT:
Retinal Detatchment
Relative
4 Drugs that have no effect on seizure duration:
Methohexital, Dex, Clonidine, Esmolol
Increase/Decreases Seizure duration:
Etomidate
Increases
also causes mycolonus and increaes risk of PONV and is associated with more ECT
Increase/Decreases Seizure duration:
Alfentanyl and Fent
Alfent- increases
Fent - decreases
Increase/Decreases Seizure duration:
Lidocaine
decreases
interesting bc i thought it lowered the siezure threshold, making it more likely to have a seizure …
Increase/Decreases Seizure duration:
Propofol
decreases but blunts the hemodynamic response
T/f: methohexital has no effect on seizure duration
True
