Dean Olivia, Byford-Brooks Anthony, Hannigan Kara, Saunders Danielle, Gamble William, Kirov George
From the ECT Clinic, Hafan y Coed, University Hospital Llandough, Llandough, United Kingdom.
Department of Anaesthetics, University Hospital of Wales, Cardiff, United Kingdom.
J ECT. 2025 Jun 1;41(2):e15-e17. doi: 10.1097/YCT.0000000000001090. Epub 2024 Nov 26.
Electroconvulsive therapy (ECT) can be effective for a variety of psychiatric conditions, including for some patients who are very psychotic or agitated. Transferring such patients from the psychiatric ward to the ECT clinic can pose significant challenges for treating teams, as they try to minimize the use of restraint.
We developed a protocol for safe transfer of such patients using sedation with ketamine. An intravenous cannula is inserted on the ward in a low stimulus environment with gentle supportive holds. Intravenous ketamine is given in a bolus at 0.5-2.0 mg/kg. The patient is transported on a transfer bed to the ECT clinic within a few minutes, and usual ECT process is immediately followed.
We describe 6 patients who were given between 1 and 11 ECT treatments using this method. All of them finished ECT courses without the need for ketamine sedation. Five of them regained capacity, provided informed consent for further ECTs, and eventually reached remission.
Ketamine can be used to manage risk and transfer agitated patients to an ECT clinic for treatment.
电休克治疗（ECT）对多种精神疾病有效，包括一些极度精神病性或烦躁不安的患者。将此类患者从精神科病房转至ECT门诊对治疗团队而言可能构成重大挑战，因为他们试图尽量减少约束措施的使用。
我们制定了一项使用氯胺酮镇静来安全转运此类患者的方案。在病房低刺激环境下，通过轻柔的扶持动作插入静脉套管。静脉注射氯胺酮，剂量为0.5 - 2.0毫克/千克，推注给药。患者在几分钟内被用转运床转运至ECT门诊，随后立即进行常规ECT流程。
我们描述了6例使用该方法接受1至11次ECT治疗的患者。所有患者均完成了ECT疗程，无需氯胺酮镇静。其中5例恢复了行为能力，为进一步的ECT治疗提供了知情同意，并最终达到缓解。
氯胺酮可用于管理风险，并将烦躁不安的患者转运至ECT门诊进行治疗。
