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Circulatory Management, Especially Blood Pressure and Heart Rate

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Anesthesia Management for Electroconvulsive Therapy

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Abstract

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 unique physiological and pharmacological effects of ECT. The 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 function should be prevented by drugs, such as anticholinergic and antihypertensive agents. Ventilation should be adequately maintained to ensure the efficacy of the therapy and to stabilize 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 safety of ECT under muscle relaxation. To maintain social confidence and to refine the therapy, anesthesiologists should play an essential role in both clinical application and laboratory research on ECT.

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  1. Department of Anesthesia, Gunma Children’s Medical Center, 779 Shimohakoda, Hokkitsu, Shibukawa, Gunma, 377-8577, Japan

    Naoki Matsumoto

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  1. Gunma University Graduate School of Med., Department of Anesthesiology, Maebashi, Gunma, Japan

    Shigeru Saito

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Matsumoto, N. (2016). Circulatory Management, Especially Blood Pressure and Heart Rate. In: Saito, S. (eds) Anesthesia Management for Electroconvulsive Therapy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55717-3_5

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