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Selection of Anesthetics and Muscle Relaxants for Electroconvulsive Therapy

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Anesthesia Management for Electroconvulsive Therapy

Abstract

Although the factors influencing seizure duration during electroconvulsive therapy (ECT) remain unknown, most anesthetic and hypotonic agents have some impact on seizure duration, ictal and postictal electrophysiological variables and the clinical efficacy of ECT. When a longer seizure duration is needed, etomidate, methohexital or a combination of small doses of a short-acting opiate with propofol are used.

The use of neuromuscular relaxants is essential to ensure patient safety during ECT. Succinylcholine is commonly used for its rapid onset and recovery. In patients with a history of neuroleptic malignant syndrome or neuromuscular diseases, a more promising method of muscle relaxation is to use rocuronium-sugammadex as an alternative to succinylcholine.

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  1. Department of Anesthesiology, Gunma University Hospital, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan

    Yuji Kadoi MD, PhD

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

    Shigeru Saito

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Kadoi, Y. (2016). Selection of Anesthetics and Muscle Relaxants for Electroconvulsive Therapy. In: Saito, S. (eds) Anesthesia Management for Electroconvulsive Therapy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55717-3_3

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