Lithium: An Anaesthetic Risk

Abstract

An abnormal recovery from an anaesthetic for electro-convulsive therapy is reported. A serum hthium concentration within the toxic range without any accompanying symptoms or signs was found subsequently. The dangers of anaesthesia for patients undergoing electro-convulsive therapy and who are also receiving lithium are discussed.

Rectal Ketamine in Paediatric Anaesthesia

“…Subsequently, Mannisto and Saarnivaara (1976) found that, in mice, lithium prolonged methohexitone-induced sleep. Jephcott and Kerry (1974) were unable to explain the high plasma lithium concentration in their patient, since she had previously been well controlld.e Since anaesthetics affect membrane permeability, it may be postulated that such drugs cause short-term changes in the distribution of lithium.…”

A prospective comparative study of interaction between lithium and modified electroconvulsive therapy

“…Since most of the earlier reports on complications of combining lithium and ECT were uncontrolled case reports and case series, we cannot directly compare our results to the previous reports. One needs to consider the fact that in several such reports, there were conditions, which would make patients vulnerable to side effects, namely, elderly age group (Jephcott and Kerry 1974;DePaulo et al 1982), brain lesions (Hagen 1976), high serum lithium levels (Jephcott and Kerry 1974;Hoenig and Chaulk 1977). Consistent with the latter fi nding, even in our study, the two patients who had the highest serum levels also took the longest to recover and had longest apnea time.…”

Psychotropic and Medical Drug Interactions

“…The twitch response recovered fully after the patient was given atropine and neostigmine methyl sul fate, indicating that the delayed twitch recov ery was of no clinical significance. Jcphcott and Kerry [198] reported a case of a 64-yearold woman whose spontaneous respiration re turned as expected but who could not be roused for over 2 h after ECT. The anesthesia had been induced with 60 mg of methohexitone sodium followed by 30 mg of suxame thonium bromide.…”