Regional cerebral oxygen saturation during electroconvulsive therapy: monitoring by near-infrared spectrophotometry.
Electroconvulsive therapy (ECT) increases neuronal energy consumption and alters systemic hemodynamics. We examined the effects of ECT on regional cerebral oxygen saturation (rSo2) using a near-infrared spectro-photometer. Heart rate (HR), mean arterial blood pressure (MAP), and rSo2 were continuously monitored throughout ECT under general anesthesia in 43 patients. In all subjects, rSo2 changed in a consistent pattern during ECT, initially decreasing (-9.4% +/- 0.9%) just after application of the electrical current and subsequent increasing (8.7% +/- 0.9%) beyond the pre-ECT value. A close correlation was demonstrated between the increase in rSo2 and the mean blood pressure after the electrical shock (r2 = 0.832, P < 0.0001). We conclude that ECT initially may increase cerebral metabolic rate of oxygen more than cerebral blood flow and that rapidly increasing blood pressure transiently may overwhelm cerebral pressure autoregulation.
Saito
S
S
Department of Anesthesiology and Reanimatology, Gunma University School of Medicine, Maebashi, Japan.
Miyoshi
S
S
Yoshikawa
D
D
Shimada
H
H
Morita
T
T
Kitani
Y
Y
D000768:Anesthesia, General; D001794:Blood Pressure; D001921:Brain / Q000378:metabolism*; D002560:Cerebrovascular Circulation; D004565:Electroconvulsive Therapy; D004734:Energy Metabolism; D005260:Female; D006339:Heart Rate; D006706:Homeostasis; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000378:metabolism; D010101:Oxygen Consumption; D019265:Spectroscopy, Near-Infrared