• Best Pract Res Clin Anaesthesiol · Jul 2021

    Review

    Challenges and pitfalls in anesthesia for electroconvulsive therapy.

    • Martin Soehle, Janina Bochem, Sarah Kayser, Jan Weyerhäuser, and Ricard Valero.
    • Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany. Electronic address: martin.soehle@ukbonn.de.
    • Best Pract Res Clin Anaesthesiol. 2021 Jul 1; 35 (2): 181-189.

    AbstractElectroconvulsive therapy (ECT) refers to the application of electricity to the patients' scalp to treat psychiatric disorders, most notably, treatment-resistant depression. It is a safe, effective, and evidence-based therapy that is performed with general anesthesia. Muscle relaxation is used to prevent injuries related to the tonic-clonic seizure caused by ECT. Hypnotics are administered to induce amnesia and unconsciousness, so that, patients do not experience the period of muscle relaxation, while the generalized seizure is left unnoticed. For the anesthesiologist, ECT is associated with the challenges and pitfalls that are related to informed consent, social acceptance of ECT, airway management (especially in COVID-19 patients), and the interaction between ventilation and anesthetics from one viewpoint, and seizure induction and maintenance from another. The exact mode of action of the therapy is as unknown as the optimal choice or combination of anesthetics used.Copyright © 2020 Elsevier Ltd. All rights reserved.

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