Depression and Electroconvulsive Therapy: Review of Current Anesthesia Considerations
ABSTRACT
Electroconvulsive therapy (ECT) is becoming increasingly popular in the treatment of medication-resistant depression. Understanding the concepts behind the physiological changes brought upon by the stimulus as well as the rationale behind the various pharmacologic agents used during the procedure is crucial in providing safe and effective ECT. This review will discuss the general principles of perioperative management of anesthesia for ECT with particular focus on currently used pharmacologic agents during the procedure.
Electroconvulsive therapy (ECT) is becoming increasingly popular in the treatment of medication-resistant depression. Understanding the concepts behind the physiological changes brought upon by the stimulus as well as the rationale behind the various pharmacologic agents used during the procedure is crucial in providing safe and effective ECT. This review will discuss the general principles of perioperative management of anesthesia for ECT with particular focus on currently used pharmacologic agents during the procedure.
Cite this paper
Choi, P. , Pisklakov, S. , Tilak, V. & Xiong, M. (2013). Depression and Electroconvulsive Therapy: Review of Current Anesthesia Considerations. Open Journal of Depression, 2, 32-34. doi: 10.4236/ojd.2013.23007.
Choi, P. , Pisklakov, S. , Tilak, V. & Xiong, M. (2013). Depression and Electroconvulsive Therapy: Review of Current Anesthesia Considerations. Open Journal of Depression, 2, 32-34. doi: 10.4236/ojd.2013.23007.
References
[1] Bruce, V., Bailine, S., Petrides, G., et al. (2003). Indications for the use of propofol in electroconvulsive therapy. Journal of ECT, 19, 129-132. doi:10.1097/00124509-200309000-00002 [2] Birmaher, B., Brent, D., et al. (1998). Summary of the practice parameters for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 1234-1238. doi:10.1097/00004583-199811000-00029 [3] Boylan, L., Haskett, R., et al. (2000). Determinants of seizure threshold in ECT: Benzodiazepine use, anesthetic dosage, and other factors. Journal of ECT, 16, 3-18. doi:10.1097/00124509-200003000-00002 [4] Calarge, C., Crowe, R., et al. (2003). The comparative effects of sevoflurane and methohexital for electroconvulsive therapy. Journal of ECT, 19, 221. doi:10.1097/00124509-200312000-00008 [5] Chanpattana, W. (2001). Anesthesia for ECT. German Journal of Psychiatry, 4, 33-39. [6] Choudhury, M., Kapoor, P., et al. (2010). A randomized trial of anesthetic induction agents in patients with coronary artery disease and left ventricular dysfunction. Annals of Cardiac Anaesthesia, 13, 217. doi:10.4103/0971-9784.69057 [7] Conway, C., & Nelson L. (2001). The combined use of bupropion, lithium, and venlafaxine during ECT: A case of prolonged seizure activity. Journal of ECT, 17, 216-218. doi:10.1097/00124509-200109000-00014 [8] Ding, Z., & White, P. (2002). Anesthesia for electroconvulsive therapy. Anesthesia & Analgesia, 94, 1351-1364. doi:10.1097/00000539-200205000-00057 [9] Dolenc, T., & Rasmussen, K. (2005). The safety of electroconvulsive therapy and lithium in combination: A case series and review of the literature. Journal of ECT, 21, 165-170. doi:10.1097/01.yct.0000174383.96517.77 [10] Eranti, S., Mogg, A., et al. (2009). Methohexitone, propofol and etomidate in electroconvulsive therapy for depression: A naturalistic comparison study. Journal of Affective Disorders, 113, 165-171. doi:10.1016/j.jad.2008.03.004 [11] Folk, J., Kellner, C., et al. (2000). Anesthesia for electroconvulsive therapy: A review. Journal of ECT, 16, 157-170. doi:10.1097/00124509-200006000-00007 [12] Hiatt, N. (1963). Comparative results of methohexital sodium and thiopental sodium used during out-patient general anesthesia (A doubleblind study). Journal of the American Dental Society of Anesthesiology, 10, 94. [13] Hooten, W., & Rasmussen K. (2008). Effects of general anesthetic agents in adults receiving electroconvulsive therapy: A systematic review. J ECT, 24, 208-223. doi:10.1097/YCT.0b013e31815bfe2a [14] Hoshi, H., Kadoi, Y., et al. (2011). Use of rocuronium-sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy. Journal of Anesthesia, 25, 286-290. doi:10.1007/s00540-011-1095-6 [15] Jabre, P., Combes, X., et al. (2009). Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: A multicentre randomised controlled trial. The Lancet, 374, 293-300. doi:10.1016/S0140-6736(09)60949-1 [16] Janis, K., Hess, J., et al. (1995). Substitution of mivacurium for succinylcholine for ECT in elderly patients. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 42, 612-613. doi:10.1007/BF03011879 [17] Kenning, T., Mago, R., et al. (2012). Electroconvulsive therapy: A review of its current status. Jefferson Journal of Psychiatry, 19, 1. [18] Kellner, C., & Bryson, E. (1998). Anesthesia advances add to safety of ECT. Psychiatric Times, 29, 16-18. [19] Mayo, C., Kaye, A., et al. (2010). Update on anesthesia considerations for electroconvulsive therapy. Middle East Journal of Anesthesiology, 20, 493-498. [20] Morgan, C., Curran, H., et al. (2012). Ketamine use: A review. Addiction, 107, 27-38. doi:10.1111/j.1360-0443.2011.03576.x [21] Rasmussen, K., Jarvis, M., et al. (1996). Ketamine anesthesia in electroconvulsive therapy. Journal of ECT, 12, 217-223. [22] Rasmussen, K., Jarvis, M., et al. (1999). Low-dose atropine in electroconvulsive therapy. Journal of ECT, 15, 213-221. doi:10.1097/00124509-199909000-00006 [23] Saito, S. (2005). Anesthesia management for electroconvulsive therapy: Hemodynamic and respiratory management. Journal of Anesthesia, 19, 142-149. doi:10.1007/s00540-004-0288-7 [24] Schak, K., Mueller, P., et al. (2008). The safety of ECT in patients with chronic obstructive pulmonary disease. Psychosomatics, 49, 208-211. doi:10.1176/appi.psy.49.3.208 [25] Spitalnic, S., Blazes, C., et al. (2000). Conscious sedation: A primer for outpatient procedures. Hospital Physician, 36, 22-32. [26] Taylor, S. (2007). Electroconvulsive therapy: A review of history, patient selection, technique, and medication management. Southern Medical Journal, 100, 494-498. doi:10.1097/SMJ.0b013e318038fce0 [27] Uppal, V., Dourish, J., et al. (2010). Anaesthesia for electroconvulsive therapy. Continuing Education in Anaesthesia, Critical Care & Pain, 10, 192-196. doi:10.1093/bjaceaccp/mkq039 [28] Wagner, K., Mollenberg, O., et al. (2005). Guide to anaesthetic selection for electroconvulsive therapy. CNS Drugs, 19, 745-747. doi:10.2165/00023210-200519090-00002 [29] Walder, B., Seeck, M., et al. (2001). Propfol versus methohexital for electroconvulsive therapy: A meta-analysis. Journal of Neurosurgical Anesthesiology, 13, 93-98. doi:10.1097/00008506-200104000-00005 [30] Figiel, G., DeLeo, B., et al. (1993). Combined use of labetalol and nifedipine in controlling the cardiovascular response from ECT. Journal of Geriatric Psychiatry and Neurology, 6, 20-24. [31] Zhang, Y., White, P., et al. (2005). The use of nicardipine for electroconvulsive therapy: A dose-ranging study. Anesthesia & Analgesia, 100, 378-381. doi:10.1213/01.ANE.0000144419.44481.59
[1] Bruce, V., Bailine, S., Petrides, G., et al. (2003). Indications for the use of propofol in electroconvulsive therapy. Journal of ECT, 19, 129-132. doi:10.1097/00124509-200309000-00002 [2] Birmaher, B., Brent, D., et al. (1998). Summary of the practice parameters for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 1234-1238. doi:10.1097/00004583-199811000-00029 [3] Boylan, L., Haskett, R., et al. (2000). Determinants of seizure threshold in ECT: Benzodiazepine use, anesthetic dosage, and other factors. Journal of ECT, 16, 3-18. doi:10.1097/00124509-200003000-00002 [4] Calarge, C., Crowe, R., et al. (2003). The comparative effects of sevoflurane and methohexital for electroconvulsive therapy. Journal of ECT, 19, 221. doi:10.1097/00124509-200312000-00008 [5] Chanpattana, W. (2001). Anesthesia for ECT. German Journal of Psychiatry, 4, 33-39. [6] Choudhury, M., Kapoor, P., et al. (2010). A randomized trial of anesthetic induction agents in patients with coronary artery disease and left ventricular dysfunction. Annals of Cardiac Anaesthesia, 13, 217. doi:10.4103/0971-9784.69057 [7] Conway, C., & Nelson L. (2001). The combined use of bupropion, lithium, and venlafaxine during ECT: A case of prolonged seizure activity. Journal of ECT, 17, 216-218. doi:10.1097/00124509-200109000-00014 [8] Ding, Z., & White, P. (2002). Anesthesia for electroconvulsive therapy. Anesthesia & Analgesia, 94, 1351-1364. doi:10.1097/00000539-200205000-00057 [9] Dolenc, T., & Rasmussen, K. (2005). The safety of electroconvulsive therapy and lithium in combination: A case series and review of the literature. Journal of ECT, 21, 165-170. doi:10.1097/01.yct.0000174383.96517.77 [10] Eranti, S., Mogg, A., et al. (2009). Methohexitone, propofol and etomidate in electroconvulsive therapy for depression: A naturalistic comparison study. Journal of Affective Disorders, 113, 165-171. doi:10.1016/j.jad.2008.03.004 [11] Folk, J., Kellner, C., et al. (2000). Anesthesia for electroconvulsive therapy: A review. Journal of ECT, 16, 157-170. doi:10.1097/00124509-200006000-00007 [12] Hiatt, N. (1963). Comparative results of methohexital sodium and thiopental sodium used during out-patient general anesthesia (A doubleblind study). Journal of the American Dental Society of Anesthesiology, 10, 94. [13] Hooten, W., & Rasmussen K. (2008). Effects of general anesthetic agents in adults receiving electroconvulsive therapy: A systematic review. J ECT, 24, 208-223. doi:10.1097/YCT.0b013e31815bfe2a [14] Hoshi, H., Kadoi, Y., et al. (2011). Use of rocuronium-sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy. Journal of Anesthesia, 25, 286-290. doi:10.1007/s00540-011-1095-6 [15] Jabre, P., Combes, X., et al. (2009). Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: A multicentre randomised controlled trial. The Lancet, 374, 293-300. doi:10.1016/S0140-6736(09)60949-1 [16] Janis, K., Hess, J., et al. (1995). Substitution of mivacurium for succinylcholine for ECT in elderly patients. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 42, 612-613. doi:10.1007/BF03011879 [17] Kenning, T., Mago, R., et al. (2012). Electroconvulsive therapy: A review of its current status. Jefferson Journal of Psychiatry, 19, 1. [18] Kellner, C., & Bryson, E. (1998). Anesthesia advances add to safety of ECT. Psychiatric Times, 29, 16-18. [19] Mayo, C., Kaye, A., et al. (2010). Update on anesthesia considerations for electroconvulsive therapy. Middle East Journal of Anesthesiology, 20, 493-498. [20] Morgan, C., Curran, H., et al. (2012). Ketamine use: A review. Addiction, 107, 27-38. doi:10.1111/j.1360-0443.2011.03576.x [21] Rasmussen, K., Jarvis, M., et al. (1996). Ketamine anesthesia in electroconvulsive therapy. Journal of ECT, 12, 217-223. [22] Rasmussen, K., Jarvis, M., et al. (1999). Low-dose atropine in electroconvulsive therapy. Journal of ECT, 15, 213-221. doi:10.1097/00124509-199909000-00006 [23] Saito, S. (2005). Anesthesia management for electroconvulsive therapy: Hemodynamic and respiratory management. Journal of Anesthesia, 19, 142-149. doi:10.1007/s00540-004-0288-7 [24] Schak, K., Mueller, P., et al. (2008). The safety of ECT in patients with chronic obstructive pulmonary disease. Psychosomatics, 49, 208-211. doi:10.1176/appi.psy.49.3.208 [25] Spitalnic, S., Blazes, C., et al. (2000). Conscious sedation: A primer for outpatient procedures. Hospital Physician, 36, 22-32. [26] Taylor, S. (2007). Electroconvulsive therapy: A review of history, patient selection, technique, and medication management. Southern Medical Journal, 100, 494-498. doi:10.1097/SMJ.0b013e318038fce0 [27] Uppal, V., Dourish, J., et al. (2010). Anaesthesia for electroconvulsive therapy. Continuing Education in Anaesthesia, Critical Care & Pain, 10, 192-196. doi:10.1093/bjaceaccp/mkq039 [28] Wagner, K., Mollenberg, O., et al. (2005). Guide to anaesthetic selection for electroconvulsive therapy. CNS Drugs, 19, 745-747. doi:10.2165/00023210-200519090-00002 [29] Walder, B., Seeck, M., et al. (2001). Propfol versus methohexital for electroconvulsive therapy: A meta-analysis. Journal of Neurosurgical Anesthesiology, 13, 93-98. doi:10.1097/00008506-200104000-00005 [30] Figiel, G., DeLeo, B., et al. (1993). Combined use of labetalol and nifedipine in controlling the cardiovascular response from ECT. Journal of Geriatric Psychiatry and Neurology, 6, 20-24. [31] Zhang, Y., White, P., et al. (2005). The use of nicardipine for electroconvulsive therapy: A dose-ranging study. Anesthesia & Analgesia, 100, 378-381. doi:10.1213/01.ANE.0000144419.44481.59