Wojdacz Rafał, Święcicki Łukasz, Antosik-Wójcińska Anna
Instytut Psychiatrii i Neurologii w Warszawie.
II Klinika Psychiatryczna, Instytut Psychiatrii i Neurologii w Warszawie.
Psychiatr Pol. 2017 Dec 30;51(6):1039-1058. doi: 10.12740/PP/75635.
Electroconvulsive therapy (ECT) is the treatment method widely used in psychiatric disorders such as depression, bipolar disorder, schizophrenia and schizoaffective disorder. The advantage of ECT is therapeutic response that occurs significantly earlier than during pharmacotherapy. Initially ECTwas used without anesthesia. Then, in the 1950s procedures with general anesthesia were introduced to reduce the complications that may occur during a seizure caused by ECT, such as broken bones, teeth, tendon rupture, muscle damage. Currently, in general anesthesia for ECTseveral medications are used interchangeably: thiopental, propofol, etomidate and ketamine. In different resorts and different countries different anestethics are used, the choice is determined mainly by the experience of each resort and a kind of tradition. The authors provide an overview of objective data showing how various anesthetics affect the quality of ECT and the presence of any hemodynamic complications after ETC. Selection of articles included in this paper was made by searching Medline and PubMed databases using specific keywords: electroconvulsive therapy, general anesthesia, the risks and benefits of thiopental, ketamine, propofol and etomidate. The results of this review are inconclusive when it comes to the effect of intravenous anesthetics on the quality of the ECT treatment and side effects relating to respiratory and cardiovascular system. On this basis it is impossible to determine which of intravenous anesthetics is most advantageous from the point of view of the patient. To develop the optimum scheme of anesthesia for ECT, it is necessary to conduct further, methodologically correct studies.
电休克疗法（ECT）是一种广泛应用于治疗抑郁症、双相情感障碍、精神分裂症和分裂情感性障碍等精神疾病的治疗方法。ECT的优势在于其治疗反应比药物治疗显著更早出现。最初，ECT在无麻醉的情况下使用。随后，在20世纪50年代引入了全身麻醉程序，以减少ECT引发的癫痫发作期间可能出现的并发症，如骨折、牙齿损伤、肌腱断裂、肌肉损伤。目前，在ECT的全身麻醉中，几种药物可交替使用：硫喷妥钠、丙泊酚、依托咪酯和氯胺酮。在不同的疗养地和不同的国家，使用不同的麻醉剂，选择主要取决于每个疗养地的经验和一种传统。作者提供了客观数据的概述，展示了各种麻醉剂如何影响ECT的质量以及ETC后是否存在任何血流动力学并发症。本文纳入文章的选择是通过使用特定关键词搜索Medline和PubMed数据库进行的：电休克疗法、全身麻醉、硫喷妥钠、氯胺酮、丙泊酚和依托咪酯的风险和益处。当涉及静脉麻醉剂对ECT治疗质量的影响以及与呼吸和心血管系统相关的副作用时，本综述的结果尚无定论。基于此，从患者的角度无法确定哪种静脉麻醉剂最具优势。为了制定ECT的最佳麻醉方案，有必要进行进一步的、方法正确的研究。
