电休克治疗中当前麻醉药物的叙述性概述
A Narrative Overview of Current Anesthetic Drugs in Electroconvulsive Therapy.
作者信息
Lee Kevin, Jenkins Kimberly D, Sparkle Tanaya
机构信息
Department of Anesthesiology, University of Toledo Medical Center, Toledo, OH 43614, USA.
出版信息
Life (Basel). 2021 Sep 18;11(9):981. doi: 10.3390/life11090981.
Abstract
Electroconvulsive therapy (ECT) is a definitive treatment for patients with psychiatric disorders that are severe, acute, or refractory to pharmacologic therapy. Providing anesthesia for ECT is challenging, as the effect of drugs on hemodynamics, seizure duration, comfort, and recovery must be considered. We highlight and aim to review the common anesthetics used in ECT and related evidence. While drugs such as methohexital, succinylcholine, and etomidate have been used in the past, other drugs such as dexmedetomidine, ketamine, and remifentanil may provide a more balanced anesthetic with a greater safety profile in select populations. Overall, it is essential to consider the patient's co-morbidities and associated risks when deciding on an anesthetic drug.
摘要
电休克治疗（ECT）是治疗严重、急性或药物治疗无效的精神疾病患者的一种确定性治疗方法。为ECT提供麻醉具有挑战性，因为必须考虑药物对血流动力学、癫痫发作持续时间、舒适度和恢复的影响。我们重点介绍并旨在回顾ECT中常用的麻醉剂及相关证据。虽然过去曾使用过诸如美索比妥、琥珀胆碱和依托咪酯等药物，但其他药物如右美托咪定、氯胺酮和瑞芬太尼在特定人群中可能提供更平衡的麻醉且安全性更高。总体而言，在决定使用麻醉药物时，考虑患者的合并症和相关风险至关重要。
相似文献
1
A Narrative Overview of Current Anesthetic Drugs in Electroconvulsive Therapy.
Life (Basel). 2021 Sep 18;11(9):981. doi: 10.3390/life11090981.
2
Comparison of etomidate and methohexital as anesthetic agents for continuation and maintenance electroconvulsive therapy: A retrospective analysis of seizure quality and safety.
J Affect Disord. 2023 Jun 1;330:33-39. doi: 10.1016/j.jad.2023.02.085. Epub 2023 Feb 28.
3
Ketamine Anesthesia Does Not Improve Depression Scores in Electroconvulsive Therapy: A Randomized Clinical Trial.
J Neurosurg Anesthesiol. 2018 Oct;30(4):305-313. doi: 10.1097/ANA.0000000000000511.
4
Customized anesthetic preservation of ictal threshold in electroconvulsive therapy: role of adjunctive remifentanil with etomidate.
J ECT. 2005 Jun;21(2):128-31. doi: 10.1097/01.yct.0000167463.71704.52.
5
The effect of remifentanil on seizure duration and acute hemodynamic responses to electroconvulsive therapy.
Anesth Analg. 2003 Apr;96(4):1047-1050. doi: 10.1213/01.ANE.0000054002.65040.B3.
6
A retrospective comparison of remifentanil versus methohexital for anesthesia in electroconvulsive therapy.
J ECT. 2004 Dec;20(4):219-24. doi: 10.1097/00124509-200412000-00006.
7
A randomized comparison of ketamine versus methohexital anesthesia in electroconvulsive therapy.
Psychiatry Res. 2014 Feb 28;215(2):362-5. doi: 10.1016/j.psychres.2013.12.027. Epub 2013 Dec 21.
8
The comparative effects of methohexital, propofol, and etomidate for electroconvulsive therapy.
Anesth Analg. 1995 Sep;81(3):596-602. doi: 10.1097/00000539-199509000-00031.
9
Propofol and methohexital as anesthetic agents for electroconvulsive therapy: a randomized, double-blind comparison of electroconvulsive therapy seizure quality, therapeutic efficacy, and cognitive performance.
J ECT. 2007 Dec;23(4):239-43. doi: 10.1097/0b013e31814da971.
10
Electroconvulsive therapy: recent advances and anesthetic considerations.
Curr Opin Anaesthesiol. 2023 Aug 1;36(4):441-446. doi: 10.1097/ACO.0000000000001279. Epub 2023 Jun 8.
引用本文的文献
1
Dexmedetomidine for modified electroconvulsive therapy: a dose-optimized treatment study.
Eur J Med Res. 2025 Apr 4;30(1):241. doi: 10.1186/s40001-025-02509-3.
2
Effect of Intravenous Injection of Magnesium Sulphate on Intraoperative End-Tidal CO Level and Postoperative Pain in Laparoscopic Cholecystectomy.
Anesth Pain Med. 2023 Dec 31;13(6):e135189. doi: 10.5812/aapm-135189. eCollection 2023 Dec.
3
Assessment of seizure duration and utility of using SedLine EEG tracing in veterans undergoing electroconvulsive therapy: a retrospective analysis.
J Anesth Analg Crit Care. 2024 Feb 6;4(1):8. doi: 10.1186/s44158-024-00143-9.
4
Dexmedetomidine Regulates the miR-146a-5p/NF-B Axis to Alleviate Electroconvulsive Therapy-Induced Cognitive Impairments.
Comput Math Methods Med. 2022 Oct 4;2022:8371492. doi: 10.1155/2022/8371492. eCollection 2022.
本文引用的文献
1
Quantification of fracture rate during electroconvulsive therapy (ECT) using state-mandated reporting data.
Brain Stimul. 2020 May-Jun;13(3):523-524. doi: 10.1016/j.brs.2019.12.007. Epub 2019 Dec 12.
2
Effects of Ketamine Anesthesia on Efficacy, Tolerability, Seizure Response, and Neurocognitive Outcomes in Electroconvulsive Therapy: A Comprehensive Meta-analysis of Double-Blind Randomized Controlled Trials.
J ECT. 2020 Jun;36(2):94-105. doi: 10.1097/YCT.0000000000000632.
3
The effectiveness of BIS monitoring during electro-convulsive therapy: A systematic review and meta-analysis.
J Clin Anesth. 2019 Dec;58:100-104. doi: 10.1016/j.jclinane.2019.05.006. Epub 2019 May 28.
4
Anesthesia Management of Special Patient Populations Undergoing Electroconvulsive Therapy: A Review.
J Nippon Med Sch. 2019;86(2):70-80. doi: 10.1272/jnms.JNMS.2019_86-202.
5
Adjunctive ketamine and electroconvulsive therapy for major depressive disorder: A meta-analysis of randomized controlled trials.
J Affect Disord. 2019 May 1;250:123-131. doi: 10.1016/j.jad.2019.02.044. Epub 2019 Feb 18.
6
Ketamine in electroconvulsive therapy for depressive disorder: A systematic review and meta-analysis.
J Psychiatr Res. 2018 Sep;104:144-156. doi: 10.1016/j.jpsychires.2018.07.003. Epub 2018 Jul 7.
7
Anesthesia for electroconvulsive therapy.
Curr Opin Anaesthesiol. 2018 Oct;31(5):501-505. doi: 10.1097/ACO.0000000000000624.
8
Ketamine and electroconvulsive therapy: so happy together?
Curr Opin Anaesthesiol. 2018 Aug;31(4):459-462. doi: 10.1097/ACO.0000000000000607.
9
Effectiveness of dexmedetomidine as premedication prior to electroconvulsive therapy, a Randomized controlled cross over study.
Indian J Psychiatry. 2017 Jul-Sep;59(3):370-374. doi: 10.4103/psychiatry.IndianJPsychiatry_33_17.
10
How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms.
Clin Psychopharmacol Neurosci. 2017 Aug 31;15(3):210-221. doi: 10.9758/cpn.2017.15.3.210.
Zotero 插件