Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,
Department of Psychiatry, McLean Hospital, Belmont, Massachusetts, USA,
Psychother Psychosom. 2020;89(5):314-319. doi: 10.1159/000509113. Epub 2020 Jun 18.
Electroconvulsive therapy (ECT) is a critical procedure in psychiatric treatment, but as typically delivered involves the use of bag-mask ventilation (BMV), which during the COVID-19 pandemic exposes patients and treatment staff to potentially infectious aerosols.
To demonstrate the utility of a modified anesthesia protocol for ECT utilizing preoxygenation by facemask and withholding the use of BMV for only those patients who desaturate during the apneic period.
This chart review study analyzes patients who were treated with ECT using both the traditional and modified anesthesia protocols.
A total of 106 patients were analyzed, of whom 51 (48.1%) required BMV using the new protocol. Of clinical factors, only patient BMI was significantly associated with the requirement for BMV. Mean seizure duration reduced from 52.0 ± 22.4 to 46.6 ± 17.1 s, but seizure duration was adequate in all cases. No acute physical, respiratory, or psychiatric complications occurred during treatment.
A modified anesthesia protocol reduces the use of BMV by more than 50%, while retaining adequate seizure duration.
电痉挛疗法（ECT）是精神科治疗中的一项关键程序，但通常需要使用袋面罩通气（BMV），而在 COVID-19 大流行期间，这会使患者和治疗人员暴露于潜在感染性气溶胶中。
展示一种改良的 ECT 麻醉方案的实用性，该方案通过面罩进行预充氧，并仅在那些在呼吸暂停期间出现血氧饱和度下降的患者中使用 BMV。
本回顾性图表研究分析了使用传统和改良麻醉方案进行 ECT 治疗的患者。
共分析了 106 名患者，其中 51 名（48.1%）需要使用新方案进行 BMV。在临床因素中，只有患者 BMI 与 BMV 的需求显著相关。平均癫痫发作持续时间从 52.0±22.4 秒减少至 46.6±17.1 秒，但所有情况下的癫痫发作持续时间均足够。在治疗过程中未发生急性身体、呼吸或精神并发症。
改良的麻醉方案可将 BMV 的使用减少 50%以上，同时保持足够的癫痫发作持续时间。
