Page 1 of 2: Anaesthesia for ECT

Rueeta · Credits: 5561 My Scrapbook My Reading List 61 Books

can someone give me the details about anasthesia used for Electro Convulsive Therapy (ECT)?
any specific agent preferred for ECT, methohexitone.

legaldevil · Credits: 2816 My Scrapbook

Multiple independent investigators have reported that propofol anesthesia during electroconvulsive therapy (ECT) is associated with substantially shorter ECT seizure duration than barbiturate anesthesia, which evidences seizure obstruction by propofol. Seizure length after propofol narcosis is often below the 20-30 s range accepted as minimally adequate. Seizure-induced elevations of prolactin, adrenocorticotropic hormone, and cortisol are similarly lower after propofol. Together with a recent report that average course length with propofol exceeds 16 sessions, this report indicates that propofol is undesirable for routine ECT anesthesia, and also illustrates how aspects of ECT anesthesia that affect the psychiatric or behavioral outcome require the collaboration of a psychiatrist.

Rueeta · Credits: 5561 My Scrapbook My Reading List 61 Books

Thanks "legal devil" but can u give me what is usually done for GA during ECT..

drsmita_s · Credits: 18609 My Scrapbook

I'M SURE ABOUT ONE THING THAT METHOHEXITAL IS THE INDUCTION AGENT OF CHOICE IN ECT.
SUCCINYLCHOLINE MAY BE USED TO PREVENT MUSCLE CONTRACTION.

Rueeta · Credits: 5561 My Scrapbook My Reading List 61 Books

Hey thanks smita.... is methohexital used because it has some epileptogenic effect or something??/
Actually i've read it somewhere while preparing for the entrances but I would be glad if u can find me a reference from some anesthesia text cuz my lect wants it.....

Rueeta · Credits: 5561 My Scrapbook My Reading List 61 Books

Methohexital (marketed under the brand name Brevital) is a drug which is a barbiturate derivative. It is classified as short-acting, and has a rapid onset of action. It is similar in its effects to thiopentone, a drug with which it competed in the market for anaesthetics.

SIDE EFFECTS

Side effects associated with Brevital Sodium are extensions of pharmacologic effects and include:

Cardiovascular—Circulatory depression, thrombophlebitis, hypotension, tachycardia, peripheral vascular collapse, and convulsions in association with cardiorespiratory arrest

Respiratory—Respiratory depression (including apnea), cardiorespiratory arrest, laryngospasm, bronchospasm, hiccups, and dyspnea

Neurologic—Skeletal muscle hyperactivity (twitching), injury to nerves adjacent to injection site, and seizures

Psychiatric—Emergence delirium, restlessness, and anxiety may occur, especially in the presence of postoperative pain

Gastrointestinal—Nausea, emesis, abdominal pain, and liver function tests abnormal

Allergic—Erythema, pruritus, urticaria, and cases of anaphylaxis have been reported rarely

Other—Other adverse reactions include pain at injection site, salivation, headache, and rhinitis

But There is no mention of ECT as a Specific Indication on any site!!! Can someone give me a reference???

thakurda · Credits: 1233 My Scrapbook My Reading List 42 Books

electro convulsive thaerpy ECT may be without Anaesthesia and can be modified by a short lasting Anaesthesia .

Induction thiopentone / propofol.
NMJ blocker succinylcholine or (fazadinium not available)
Bag mask ventilation FiO2 1
Bite block insertion
Electric shock monopolar / bipolar electrode
Recovery in the post tonsillectomy position

NB methohexitone having [i]epileptogenic properties[/] is not recommended

Rueeta · Credits: 5561 My Scrapbook My Reading List 61 Books

thanks

kskarthik · Credits: 291 My Scrapbook

i think its the other way around
in ECT the therapeutid effect is said to be partly due to the seizures it produces
so
- u prefer drugs with epileptogenic potential than the one which prevents it
- So rationally Methohexitone would be the best option
- of course propofol is also preferred as it has a very short recovery period

konveer · Credits: 640 My Scrapbook

yes methohexitone and succinyl choline are preferred

		Sign In New User? Sign Up Sign in to access your control panel and messenger!
				TechZone \| SpiderNevi \| HowTo? \| Scrapbook!