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Postprocedural Assessments and Considerations

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Anesthesia Management for Electroconvulsive Therapy

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Abstract

Postictal agitation is a frequent complication during the emergence period after ECT. This symptom commonly resolves naturally within 1 h, but a severe or persistent episode requires pharmacological treatment with benzodiazepines or propofol to control the acute situation. Hypoxemia following ECT can also occur in this period, and monitoring of oxygen saturation should be continued until psychomotor function resumes. When desaturation is prolonged, initial pulmonary aspiration of increased saliva or gastric contents is suggested. Patients generally require about 2 h of post-ECT care in the recovery room and adverse symptoms, especially headache, should be noted. Elderly patients have a high risk of fall and should be monitored carefully. Memory disturbance is an important cognitive impairment during and after ECT course and may impair optimal functioning. In some cases, ECT parameters should be modified based on the assessment of cognitive function to minimize this adverse effect. Continuation/maintenance ECT is an effective treatment option for relapse prevention after successful treatment with index ECT and is often performed in an ambulatory setting. The decision to transfer the patient from inpatient to ambulatory ECT requires careful assessment of the treatment response and adverse effects of ECT.

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  1. Department of Anesthesia, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Masami Sato

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Correspondence to Masami Sato .

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

    Shigeru Saito

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Sato, M. (2016). Postprocedural Assessments and Considerations. In: Saito, S. (eds) Anesthesia Management for Electroconvulsive Therapy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55717-3_6

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