Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Acta Anaesthesiol Scand. 2012 Jan;56(1):3-16. doi: 10.1111/j.1399-6576.2011.02520.x. Epub 2011 Sep 26.
Electroconvulsive therapy (ECT) is the transcutaneous application of small electrical stimuli to the brain to induce generalised seizures for the treatment of selected psychiatric disorders. The clinical indications for ECT as an effective therapeutic modality have been considerably expanded since its introduction. Anaesthesia and neuromuscular blocking agents (NMBAs) are required to ensure patients' safety during ECT. The optimal dose of muscle relaxant for ECT reduces muscle contractions without inducing complete paralysis. Slight residual motor convulsive activity is helpful in ascertaining that a seizure has occurred, while total paralysis prolongs the procedure unnecessarily. Suxamethonium is commonly used, but nondepolarising NMBAs are indicated in patients with certain comorbidities. In this review, we summarise current concepts of NMBA management for ECT.
电抽搐治疗（ECT）是通过将小电流刺激经皮肤传递至大脑以诱发全身性抽搐，从而治疗特定的精神疾病。ECT 作为一种有效的治疗方式，自其问世以来，其临床适应证已得到极大扩展。在 ECT 过程中，需要使用麻醉剂和神经肌肉阻滞剂（NMBAs）来确保患者的安全。ECT 时肌松剂的最佳剂量应既能减少肌肉收缩，又不至于引起完全瘫痪。轻微的残余运动性抽搐有助于确定是否发生抽搐，而完全瘫痪则会不必要地延长手术时间。虽然常使用琥珀酰胆碱，但在存在某些合并症的患者中，应使用非去极化 NMBAs。在这篇综述中，我们总结了 ECT 时 NMBA 管理的当前概念。
