ECT in the Presence of Intracranial Aneurysm

Najjar, Fedra; Guttmacher, Laurence

doi:10.1097/00124509-199812000-00009

Cited by 20 publications

(13 citation statements)

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“…However, case reports describing unsuccessful management of ECT in patients with cerebral complications are limited [95]. In contrast, safe completion of the therapy schedule with deliberate hemodynamic management has been reported in some literature [96,[97][98][99][100][101][102]. Even though there are few previously reported catastrophic cases, anesthesiologists should take special efforts to stabilize hemodynamics and cautiously inspect neurological symptoms when ECT is administered for such patients.…”

Section: Cerebrovascular Complicationsmentioning

confidence: 99%

Anesthetic Considerations for Electroconvulsive Therapy-Especially Hemodynamic and Respiratory Management

Y¹

2009

CPSR

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Recent guidelines have stated that anesthesia for electroconvulsive therapy (ECT) should be administered by specially trained anesthesiologists. Physicians who perform ECT should have sufficient knowledge about hemodynamics as well as the physiological and pharmacologically unique effects of ECT. Electrical currents during ECT stimulate the autonomic nervous system and provoke unique hemodynamic changes in the systemic and cerebral circulation. Excessive alterations in heart rate, blood pressure, and cardiac functions should be prevented by medications with anticholinergic and antihypertensive effects. Ventilation should be adequately maintained to ensure efficacy of the therapy and to stabilize hemodynamics immediately after the electrical stimulation. Although reports of serious complications with this therapy are not frequent, patients with ischemic heart disease or cerebrovascular disease must be managed with special care to prevent myocardial infarction or neurological disorders. Appropriate physical management by physicians greatly contributes to the safe establishment of ECT under muscle relaxation. To maintain social confidence in this procedure and to further refine this therapy, physicians should play an essential role in both the clinical activities and laboratory research of ECT.

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Section: Cerebrovascular Complicationsmentioning

confidence: 99%

Anesthetic Considerations for Electroconvulsive Therapy-Especially Hemodynamic and Respiratory Management

Y¹

2009

CPSR

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“…In contrast, safe completion of the therapy schedule with deliberate hemodynamic management has been reported [45, [66][67][68][69][70][71]. Even though there are few previously reported catastrophic cases, anesthesiologists should take special effort to stabilize hemodynamics and cautiously inspect neurological symptoms when ECT is administered for such patients.…”

Section: Cerebrovascular Complicationsmentioning

confidence: 99%

Anesthesia management for electroconvulsive therapy: hemodynamic and respiratory management

Saito

2005

J Anesth

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Recent guidelines have stated that anesthesia for electroconvulsive therapy (ECT) should be administered by a specially trained anesthesiologist, and that anesthesiologists have overall responsibility, not only for anesthesia itself, but also for cardiopulmonary management and emergency care. Accordingly, anesthesiologists who administer anesthesia for ECT should have sufficient knowledge regarding the physiologically and pharmacologically unique effects of ECT. Electrical current during ECT stimulates the autonomic nervous system and provokes unique hemodynamic changes in systemic and cerebral circulation. Excessive alterations in heart rate, blood pressure, and cardiac functions should be prevented by medications with anticholinergic and antihypertensive agents. Ventilation should be adequately maintained to ensure the efficacy of the therapy and to stabilize the hemodynamics immediately after the electrical stimulation. Reports of serious complications of this therapy are not frequent; however, patients with ischemic heart disease or cerebrovascular problems must be managed with special care to prevent myocardial infarction or neurological disorders. Safe physical management by anesthesiologists greatly contributes to the establishment of ECT under muscle relaxation. To maintain social confidence and to refine the therapy, anesthesiologists should play an essential role both in clinical activities and in laboratory research.

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“…12 Our case was complicated by the recent history of aneurysmal rupture and the presence of a ventriculoperitoneal shunt. We successfully completed a course of 10 ECT sessions under carefully monitored conditions.…”

Section: Discussionmentioning

confidence: 90%

“…8 Also, anecdotally it is possible to control blood pressure rises during ECT using pharmacological interventions. 3,[8][9][10]12 However additional research is warranted to devise ECT protocols for patients with intracranial vascular masses. Until then, it is important to weigh the risks and benefits of each case, obtain a neurologic consultation and imaging study if warranted, and closely monitor blood pressure and vital signs during the procedure.…”

Section: Discussionmentioning

confidence: 99%

Electroconvulsive Therapy After Repair of Cerebral Aneurysm

Sharma¹,

Ramaswamy²,

Bhatia³

2005

The Journal of ECT

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There are cases in the literature describing the use of electroconvulsive therapy (ECT) in patients with intracerebral aneurysms. We report the clinical course of a 60-year-old woman with a history of a recently ruptured intracerebral aneurysm and placement of a ventriculoperitoneal shunt that was successfully treated with ECT for major depressive disorder. Beta blockade with esmolol 20-50 mg was used to maintain her blood pressure, which ranged from 100/63 to 170/94 mm Hg. Propofol was used for anesthesia. There were no vascular complications secondary to the ECT procedure.

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ECT in the Presence of Intracranial Aneurysm

Cited by 20 publications

References 0 publications

Anesthetic Considerations for Electroconvulsive Therapy-Especially Hemodynamic and Respiratory Management

Anesthetic Considerations for Electroconvulsive Therapy-Especially Hemodynamic and Respiratory Management

Anesthesia management for electroconvulsive therapy: hemodynamic and respiratory management

Electroconvulsive Therapy After Repair of Cerebral Aneurysm

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