title: End-tidal carbon dioxide monitoring stabilized hemodynamic changes during ECT.
abstract: Accumulation of carbon dioxide (CO2) can disturb systemic and cerebral hemodynamics in patients receiving electroconvulsive therapy (ECT). The purpose of this study was to identify the effects of end-tidal CO2 monitoring on hemodynamic changes in patients who received ECT under propofol anesthesia. ECT was prescribed to 40 patients under propofol anesthesia. Ventilation was assisted using a face mask and 100% oxygen, with or without end-tidal CO2 monitoring. Heart rate was significantly increased in patients without end-tidal CO2 monitoring at 1 to 5 minutes after electrical stimulation (p < 0.01). Mean arterial blood pressure and middle cerebral artery blood flow velocity in the group without end-tidal CO2 monitoring were significantly larger than the values in the group with the monitor at 1 to 5 minutes after electrical stimulation. Arterial CO2 tension in the group without end-tidal CO2 monitoring was larger than the value in the group with the monitoring at 1 minute (45+/-5 mm Hg with the monitor and 56+/-8 without the monitor) and 5 minutes (37+/-4 mm Hg with the monitor and 51+/-8 without the monitor) after electrical stimulation (p < 0.01). Application of end-tidal CO2 monitoring is considered beneficial for safe and effective anesthesia management of patients undergoing ECT, especially patients with an intracranial disorder or ischemic heart disease.
authors.affiliation: Department of Anesthesiology and Reanimatology, Gunma University School of Medicine, 3-39-22, Showamachi, Maebashi, 371-8511, Japan. shigerus@news.sb.gunma-u.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kadoi
authors.forename: Fumio
authors.initials: F
authors.lastname: Nihishara
authors.forename: Chizu
authors.initials: C
authors.lastname: Aso
authors.forename: Fumio
authors.initials: F
authors.lastname: Goto
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001921:Brain / Q000098:blood supply; D001927:Brain Diseases / Q000150:complications; D002245:Carbon Dioxide / Q000032:analysis*; D004565:Electroconvulsive Therapy; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017202:Myocardial Ischemia / Q000150:complications; D015742:Propofol / Q000008:administration & dosage
chemical_list: D018686:Anesthetics, Intravenous; D002245:Carbon Dioxide; D015742:Propofol