Electroconvulsive Therapy Flashcards
What is electroconvulsive therapy (ECT)?
ECT is the induction of a generalized seizure via electrodes placed on the cranium.
What is the most common complication of ECT?
Prolonged seizure, which is easily treated with benzodiazepines.
What psychiatric disorders is ECT used to treat?
Schizoaffective disorders, bipolar disorders, and major depression disorders that are resistant to medical therapy.
What are the two most common causes of death
related to electroconvulsive therapy?
Cardiac dysrhythmias and myocardial infarction are the two most common causes of death related to ECT treatment.
What are the hemodynamic effects of ECT?
ECT treatments result in stimulation of the autonomic nervous system resulting in a short-lived bradycardia followed by a surge
in endogenous catecholamines causing potentially dangerous hypertension and tachycardia.
Historically, what has been the preferred intravenous anesthetic agent for ECT? Why?
Methohexital has been used the most. All intravenous anesthetics reduce seizure activity, but methohexital reduces it the least.
What type of anesthesia is administered for ECT?
General anesthesia is induced with an intravenous agent, succinylcholine is administered to provide muscle relaxation in preparation for the seizure, and positive-pressure ventilation by mask is performed via mask (or via ETT if the patient is at risk for aspiration).
What are the anesthetic goals for ECT?
Provide airway support, prevent any recall of the procedure, and attenuate the hemodynamic response to ECT.
