Anesthesia for Electroconvulsive Therapy: A Case Report

Abstract

Background: Electroconvulsive therapy (ECT) is one of the therapeutic options in the field of psychiatry. ECT causes several conditions such as stimulation of the general autonomic nervous system, increased intracranial pressure and conditions such as headaches, myalgias, swelling, weakness, nausea and even musculoskeletal complications. Anesthetic management is required to prevent this complication in addition to its primary goal of providing total unconsciousness. The choice of anesthetic agent is chosen based on its rapid onset and duration and not interfering with the patient's seizure activity. Case Report: We present the case of a 24-year-old female who is diagnosed with schizophrenia hebephrenic. She scheduled for ECT because her symptoms were worsening over time and did not respond to oral medications. Anesthesia is given during ECT. As premedication used atropine sulfate 0.5 mg, then induced with propofol 100 mg and pethidine 50 mg. We did not use neuromuscular blocking agents and only managed ventilation patients with Jackson-Rees circuit. After multiple ECT treatment, we observed no significant clinical effect on seizure duration or hemodynamic profile. The patient's clinical and functional status also significantly improved with ECT treatment. Conclusions: Anesthesia during ECT creates a safe and comfortable environment for generalized epileptic seizures to occur. Multiple anesthetic agents are acceptable for use during ECT. Although the anesthesia given in this case has several limitations, it still produces good clinical outcomes and minimal side effects. Keywords: Electroconvulsive Therapy, Anesthesia, Propofol