Management for electroconvulsive therapy of a patient with inoperable coronary artery disease and ankylosing spondylitis.
A 69-year-old male with severe coronary artery disease, ankylosing spondylitis, and severe major depression was scheduled for electroconvulsive therapy (ECT). The patient had previously failed or proved intolerant of antidepressant drug therapy. The nature and severity of the patient's diseases and complexity of potential interactions with ECT and anesthesia required sequential assessment of hemodynamic and airway tolerances with successive treatments. Despite substantial risks for particular patients, ECT may provide the only treatment option for life-threatening psychiatric illness and warrants innovative approaches to anesthetic management.
Snyder
D S
DS
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Lipsey
J R
JR
McPherson
R W
RW
D000368:Aged; D000758:Anesthesia / Q000379:methods*; D003327:Coronary Disease / Q000150:complications*; D003866:Depressive Disorder / Q000150:complications* / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D013167:Spondylitis, Ankylosing / Q000150:complications*