Anaesthesia in electroconvulsive therapy. Special conditions

Fernández-Candil, Juan; Mascó, Laura Castelltort; Julià, N. Fàbregas; Sarachaga, Mikel Urretavizcaya; Bernardo, Miquel; Castell, R. Valero

doi:10.1016/j.rpsm.2018.05.002

Cited by 6 publications

(5 citation statements)

References 77 publications

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“…Moreover, in a review on anesthetic recommendations in electroconvulsive therapy in special conditions [ 7 ], the use of full-dose rocuronium reversed with sugammadex in short-term procedures is an acceptable alternative for patients with systemic mastocytosis.…”

Section: Resultsmentioning

confidence: 99%

“…(2014) [ 6 ] Accepted Accepted (although there are no data regarding its use) Not applicable Review of perioperative management of patients with mastocytosis Fernández-Candil et al. (2020) [ 7 ] Acceptable alternative Acceptable alternative Not applicable Review of anesthesia in electroconvulsive therapy in special conditions Unterbuchner et al. (2017) [ 8 ] Used Used (although no previous data) Yes, perioperatively Case report: Rapid sequence induction De la Fuente Tornero et al.…”

Section: Methods: Systematic Reviewmentioning

confidence: 99%

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Sugammadex in systemic mastocytosis

et al. 2021

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Perioperative management in patients suffering from systemic mastocytosis is challenging. Most recommendations regarding anesthetic management in these patients are based on clinical reports, and there are controversies about the use of rocuronium and sugammadex. We present a case report of a patient with systemic mastocytosis who was given sugammadex for rocuronium reversal. Tryptase levels were monitored during the first postoperative 24 h, without evidence of elevation. We also performed a systematic review to provide an overview of current evidence regarding the safety of using sugammadex in patients suffering from systemic mastocytosis. The search strategy included PubMed and Google Scholar. All studies published up to and including January 2021 concerning anesthetic management in systemic mastocytosis were included. Of the 122 articles located, 9 articles were included: 2 reviews and 7 case reports. Data from reviewed studies confirm that sugammadex can safely be administered in patients suffering from systemic mastocytosis.

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Section: Resultsmentioning

confidence: 99%

Section: Methods: Systematic Reviewmentioning

confidence: 99%

Sugammadex in systemic mastocytosis

et al. 2021

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“…Studies have described well that, under certain conditions, the anesthesia management of ECT patients could be very challenging (13,14). Therefore, it is crucial that patients, especially the elderly and those with comorbidities, receive ECT under safe and optimal medical conditions (15,16). Several case reports have discussed how ECT patients were affected by unexpected hazardous situations, even death (17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of the ECT Patients Preparation Checklist in Reducing the Cancellation Rate in an Academic Hospital

et al. 2022

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Background: Electroconvulsive therapy (ECT) is a vital treatment strategy for psychiatric patients, and cancellation of the procedure negatively impacts the recovery process. However, it may happen due to the lack of optimal conditions at admission. Methods: This retrospective study occurred at Shafa Hospital, an academic center affiliated with the Guilan University of Medical Sciences (GUMS). The ECT anesthesia team developed an ECT patient preparation checklist, which was shared with psychiatrists. The rate and some related factors of case cancellation were compared between the two years before presenting the checklist, from May 2019 to May 2020, and the next year, from June 2020 to May 2021. The patients’ files were reviewed, and the required information was documented. Results: One hundred fifty-one cancellations were recorded during the two years of study, 82 cases in the first year and 69 in the second year. The most common reason for the cancellation was inadequate consultations followed by abnormal lab tests. In comparing the number of cancellations between the two years, before and after the checklist was provided, no significant difference was observed in terms of age (P = 0.288), gender (P = 0.24), psychiatric disorder (P = 0.399), and the number of ECT sessions (P = 0.36). However, the number of cancellations due to incomplete consultation significantly decreased after developing the checklist (P = 0.049), while unstable hemodynamics and changing patients’ conditions on an intended day also increased (P = 0.024). Residency visits did not significantly affect the number of cancellations over 2 years (P = 0.139). Conclusions: This study concluded that preparing ECT patients according to the checklist led to better conditions and fewer cancellations. However, preventable causes still exist.

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“…Pregnancy testing should be performed in all women of reproductive age. Although pregnancy is not a contraindication for ECT, fetal exposure to anesthetics must be minimized [ 26 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Anesthetic care for electroconvulsive therapy

et al. 2022

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Counselling and medication are often thought of as the only interventions for psychiatric disorders, but electroconvulsive therapy (ECT) has also been applied in clinical practice for over 80 years. ECT refers to the application of an electric stimulus through the patient’s scalp to treat psychiatric disorders such as treatment-resistant depression, catatonia, and schizophrenia. It is a safe, effective, and evidence-based therapy performed under general anesthesia with muscle relaxation. An appropriate level of anesthesia is essential for safe and successful ECT; however, little is known about this because of the limited interest from anesthesiologists. As the incidence of ECT increases, more anesthesiologists will be required to better understand the physiological changes, complications, and pharmacological actions of anesthetics and adjuvant drugs. Therefore, this review focuses on the fundamental physiological changes, management, and pharmacological actions associated with various drugs, such as anesthetics and neuromuscular blocking agents, as well as the comorbidities, indications, contraindications, and complications of using these agents as part of an ECT procedure through a literature review and our own experiences.

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Anaesthesia in electroconvulsive therapy. Special conditions

Cited by 6 publications

References 77 publications

Sugammadex in systemic mastocytosis

Sugammadex in systemic mastocytosis

Evaluation of the Efficacy of the ECT Patients Preparation Checklist in Reducing the Cancellation Rate in an Academic Hospital

Anesthetic care for electroconvulsive therapy

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