| Unique Identifier |
16142990
|
| Authors |
Wagner
KJ. Mollenberg
O. Rentrop
M. Werner
C. Kochs
EF.
|
| Institution |
Klinik fur Anaesthesiologie, Klinikum rechts der Isar, Technische
Universitat Munchen, Munchen, Germany. K.Wagner@lrz.tum.de
|
| Title |
Guide to anaesthetic selection for electroconvulsive therapy. [Review]
[84 refs]
|
| Source |
CNS Drugs. 19(9):745-58, 2005.
|
| Abstract |
Electroconvulsive therapy (ECT) is used in the treatment of severe
psychiatric disorders. It involves the induction of a seizure for
therapeutic purposes by the administration of a variable-frequency
electrical stimulus via electrodes applied to the scalp. The original
application of ECT in non-anaesthetised patients resulted in many
traumatic effects and was replaced, in the early 1960s, with a modified
ECT regimen that used anaesthesia with neuromuscular blockade. This
remains the worldwide standard today. The development of modern ECT
devices, with improved impulse modes, has also reduced the incidence of
post-interventional cognitive adverse effects.The variety of
centrally-acting co-medications administered and the cardiovascular
effects occurring during the procedure make patients receiving ECT a
challenge for the anaesthetist. The efficacy of ECT depends on the
production of adequate seizures; however, the anaesthetic agents commonly
used during ECT suppress the generation of convulsions. Therefore, the
efficacy of ECT requires knowledge of anaesthetic precepts, understanding
of the interaction between anaesthetic drugs and seizure activity, and
awareness of the physiological effects of ECT as well as the treatment of
those effects.Successful and safe ECT depends on the correct choice of
anaesthetic drugs for the individual patient, which have to be chosen with
respect to the individual concomitant medication and pre-existing
diseases. This review provides information for the optimal selection,
set-up and practice of anaesthetic drug treatment in ECT. [References:
84]
|
| Publication Type |
Guideline. Journal Article. Practice Guideline. Review. Review,
Tutorial.
|