Başgül Elif, Celiker Varol
Hacettepe U. Tip Fak., Anestezi ve Reanimasyon AD, Ankara.
Turk Psikiyatri Derg. 2004 Fall;15(3):225-35.
Electroconvulsive therapy (ECT) is a safe and efficient procedure performed for the treatment of drug resistant depression and other psychiatric disorders. Nowadays, its administration under general anaesthesia is a worldwide process. Anaesthetic management generally involves a short acting barbiturate such as thiopental in induction followed by a muscle relaxant. Succinylcholine is the drug of choice for muscle relaxation. This approach prevents patients from suffering hazardous orthopaedic injuries due to confusion. The effectiveness of ECT depends on an adequate seizure, and so the anaesthetist should be aware of the factors that influence the duration of seizures as well as concomitant diseases and potential adverse antidepressive drug reactions. An acute haemodynamic response due to sympathetic discharge in the course of the seizure provokes abrupt cardiovascular and cerebrovascular changes such as bradycardia, tachycardia, hypertension and raised intracranial pressure. The control of responses by b-blockers and similar agents is especially important in patients with cardiac or intracerebral problems. ECT is applicable in nearly all age groups and even in pregnant subjects. The aim of this article is to review the aspects of anaesthetic management of safe and effective ECT.
电休克疗法（ECT）是一种用于治疗耐药性抑郁症和其他精神疾病的安全有效的方法。如今，在全身麻醉下进行该疗法已在全球范围内广泛应用。麻醉管理通常包括在诱导期使用短效巴比妥类药物，如硫喷妥钠，随后使用肌肉松弛剂。琥珀酰胆碱是肌肉松弛的首选药物。这种方法可防止患者因意识混乱而遭受危险的骨科损伤。ECT的有效性取决于足够的癫痫发作，因此麻醉医生应了解影响癫痫发作持续时间的因素以及伴随疾病和潜在的抗抑郁药物不良反应。癫痫发作过程中交感神经放电引起的急性血流动力学反应会引发突然的心血管和脑血管变化，如心动过缓、心动过速、高血压和颅内压升高。对于有心脏或脑部问题的患者，使用β受体阻滞剂和类似药物控制反应尤为重要。ECT几乎适用于所有年龄组，甚至适用于孕妇。本文旨在综述安全有效的ECT麻醉管理的各个方面。
