[Anesthesia for electroconvulsive therapy: clinical experience].
| Autor: | González AG; Departamento de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. gonzalea@med.puc.cl, Cortínez LI, De la Cuadra JC, Carrasco E, Rioseco A, Léniz P |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Revista espanola de anestesiologia y reanimacion [Rev Esp Anestesiol Reanim] 2007 Aug-Sep; Vol. 54 (7), pp. 414-20. |
| Abstrakt: | Objective: To assess the utility of propofol and succinylcholine in obtaining optimal convulsions and assuring patient safety during electroconvulsive therapy. Patients and Methods: This was a prospective observational study of patients undergoing electroconvulsive therapy under general anesthesia with propofol and succinylcholine. We recorded patient characteristics, doses of propofol and succinylcholine, electroencephalographically-recorded duration of convulsions, and complications. Descriptive statistics were compiled and the data were subjected to analysis of correlations, comparison with the Student t test for independent samples, the Mann-Whitney U test, and analysis of variance. Results: We studied 108 patients, 62% women and 38% men, 80% classified as ASA 1 and 20% as ASA 2. The patients underwent 844 sessions of electroconvulsive therapy; their mean (SD) age was 39.95 (18.09) years. The doses of propofol and succinylcholine were 1.34 (0.32) mgxkg(-1) and 1.35 (0.26) mgxkg(-1), respectively. The mean recorded duration of the first convulsion (29.87 [22.42] seconds) was negatively correlated with age (r = -0.12) and unrelated to propofol dose (r = 0.06) or body weight (r = 0.02). Male and schizophrenic patients had longer-lasting convulsions (P < .01). Cardiovascular complications occurred in 2.4% and psychomotor agitation in 1.4%; there were no respiratory complications, musculoskeletal injuries, nausea, or vomiting. Conclusions: Electroconvulsive therapy can be safely applied in an operating room or similar space undergeneral anesthesia and with a neuromuscular blockade in order to prevent psychological or musculoskeletal trauma. Propofol did not affect the convulsions at the dosages administered. |
| Databáze: | MEDLINE |
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