Management of Anesthesia for Electroconvulsive Therapy in Early Pregnancy: Case Report

Sargın, Asuman; Karaman, Semra; Günüşen, İlkben; Akdemir, Ali

doi:10.5336/caserep.2013-36512

Cited by 1 publication

(3 citation statements)

References 9 publications

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“…Therefore, propofol can be considered as an ideal agent for ECT during pregnancy [5,12]. Meaningfully, recent reports have indicated that propofol has been the most commonly used agent in anesthetic induction in pregnant women undergoing ECT [5,9,13-14]. In a case report by De Asis et al, ECT was applied at the 23rd gestational week in a patient with bipolar disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Neuromuscular blocking agents are used for restricting motor activity during ECT. Succinylcholine is the preferred depolarizing muscle relaxant, as it has a short-term effect [5]. Non-depolarizing neuromuscular blocking agents, another group of neuromuscular blocking agents, are generally used instead of succinylcholine in patients with different comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…ECT may be a safe procedure in pregnant patients; however, airway management may not be safe. Airway management is usually provided by a face mask in such cases since the majority of the cases have a low gestational week and a short duration of processing, mainly due to the short duration of the effects of neuromuscular blocking agents used and the early return of spontaneous breathing [5,13-14]. In our study, we used the aspiration measures mentioned above and the patients were ventilated manually with 100% oxygen 3 L/min using a face mask.…”

Section: Discussionmentioning

confidence: 99%

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The Effects of Rocuronium-sugammadex on Fetomaternal Outcomes in Pregnancy Undergoing Electroconvulsive Therapy: A Retrospective Case Series and Literature Review

Karahan¹,

Büyükfırat²,

Binici³

et al. 2019

Cureus

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Introduction The aim of this study was to evaluate the anesthesia management of pregnant patients who received electroconvulsive therapy (ECT) at our hospital and to examine the effects of this procedure on mothers and fetuses. Methods This study was conducted with 15 pregnant patients who underwent the ECT procedure who did not benefit from medical treatment or who did not want medical treatment. We evaluated the psychiatric, obstetric, and especially anesthesiology records of these patients. All of the patients received 1 mg/kg propofol with 0.6 mg/kg rocuronium. Eight mg/kg sugammadex was used to terminate the effects of the non-depolarizing neuromuscular blocking agents. Their demographic characteristics, history of diagnosis, total ECT sessions, duration of hospitalization, discharge status, neonatal outcomes, short- and long-term maternal or fetal complications, anesthetic management, and recovery parameters were retrospectively reviewed. Results Fifteen pregnant patients received a total of 95 ECT treatments. No anesthesia-related maternal complications developed. In terms of the recovery parameters of the patients, the mean duration of the motor seizure was 28.7 ± 6.3 seconds, the mean time to spontaneous respiration was 224 ± 21.8 secs, the mean time to opening the eyes was 403.6 ± 21.1 secs, and the mean time to command compliance was 415.24 ± 81.15 secs. The mean gestational week was 14.06 ± 6.65, and the mean number of pregnancies was 2.87 ± 2.29. Seven (46,7%) patients were in the first trimester of pregnancy, six (40%) were in the second trimester, and two (13.3%) were in the third trimester. Spontaneous abortion occurred in four patients, six patients gave birth by spontaneous vaginal delivery, and five patients delivered by cesarean section. Neonatal respiratory distress developed in only one fetus. Conclusion Anesthesia management during ECT can be provided safely by using propofol and rocuronium-sugammadex in pregnancy in the postoperative period. However, there is a risk of abortion and neonatal respiratory distress in the use of ECT, especially in the first trimester period. It is advisable to inform the patient's family in detail before this procedure outcome.

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