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Electroconvulsive Therapy 

Electroconvulsive Therapy
Chapter:
Electroconvulsive Therapy
Author(s):

Lisa Ross

DOI:
10.1093/med/9780190495756.003.0029
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date: 23 October 2019

The anesthetic management of patients who receive electroconvulsive therapy (ECT) for various psychiatric conditions in both the inpatient and the outpatient settings must take into account a number factors, such as its associated physiologic responses, existing comorbidities, medication management, monitoring, complications, and contraindications in order for it to remain a safe procedure. This chapter reviews the indications for ECT, the preprocedure anesthetic evaluation; theories regarding the therapeutic mechanism of action leading to the efficacy of ECT; cerebrovascular, cardiovascular, and neuroendocrine responses and monitoring standards. Furthermore, it discusses the selection of medications for induction, inhalational agents, and muscle relaxants as well as common drug interactions and premedication practices. The chapter culminates with an assessment of the morbidity and mortality associated with ECT both anesthetic and nonanesthetic related.

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