Naloxone and ECT seizure length.
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Adult↗
Biomedical subjects
K G Rasmussen
Publications and source records attributed to K G Rasmussen.
Electroconvulsive therapy in patients with aortic stenosis.
Aortic stenosis confers an increased risk of complications during procedures with general anesthesia. There are no previously reported cases of electroconvulsive therapy (ECT) in patients with this valvular defect. Two cases are described of patients with moderate to severe aortic stenosis confirmed by echocardiography in whom courses of ECT resulted in clinical improvement without untoward cardiac complications. It is concluded that ECT can be safely given to patients with aortic stenosis in whom left ventricular function is normal.
Adrenergic beta-Antagonists↗
Different caffeine preparations.
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Caffeine↗
Ketamine anesthesia in electroconvulsive therapy.
The use of ketamine anesthesia in electroconvulsive therapy (ECT) has been limited by its effects on blood pressure and concerns about untoward psychological reactions. However, because its effect on seizures is presumably less than that of methohexital, ketamine is listed as an alternative method to prolong seizure length. In this case series, 10 patients were given ketamine anesthesia during ECT. Whereas blood pressures were elevated above those seen with methohexital, seizure lengths actually decreased nonsignificantly with ketamine. There were no adverse psychological reactions noted with ketamine, which was generally well tolerated. It is concluded that ketamine anesthesia with the doses used in this series is unlikely to be associated with longer seizures in ECT. However, for theoretical reasons discussed, ketamine may be worth studying further in ECT.
Adult↗
Possible impact of stimulus duration on seizure threshold in ECT.
Seizure thresholds were measured in patients treated with right unilateral electroconvulsive therapy (ECT) using 0.9 amp, 0.5 ms constant current pulses at 30 Hz for 0.93-2.8 s. Using these parameters, only two patients failed to seize at stimulus charges < or = 75.6 mC. Three patients were excluded from further analysis because they experienced generalized motor or electrographic seizures lasting less than 25 s and 30 s, respectively. The remaining 52 patients had a mean seizure threshold of 48.9 +/- 15.3 mC. Seizure threshold was correlated with age, but not sex. These values for seizure threshold are significantly lower than those reported previously using longer pulse-briefer train duration stimuli, suggesting that characteristics of the electrical stimulus influence seizure threshold. These findings have implications for electrical dosing in right unilateral ECT.
Adult↗
Electroconvulsive therapy in patients taking theophylline.
BACKGROUND: Initiating a course of electroconvulsive therapy (ECT) in patients taking theophylline has been associated with status epilepticus and consequent brain damage or even death. However, some patients with severe pulmonary conditions may both require theophylline and be seriously depressed enough to warrant ECT. Deciding whether to use ECT in such patients is a fairly common clinical problem. METHOD: The records of seven patients taking theophylline during nine courses of ECT were reviewed to ascertain whether inordinately long seizures occurred. RESULTS: In 77 documented seizures, there was one 190-second seizure as measured by EEG. All others were shorter than 100 seconds, and mean motor and EEG seizure lengths were comparable with those reported in the literature. CONCLUSION: Theophylline coadministration is a risk factor for prolonged seizures in patients starting a course of ECT. However, in most severely depressed, medication-refractory patients, a course of ECT can be undertaken with safety. Precautions that can decrease the risk of prolonged seizures are discussed.
Adult↗