title: [Anesthetic management for electroconvulsive therapy using target-controlled infusion of propofol].
abstract: A 66-year-old man received medical treatment of depression for several years. He had a suspected malignant syndrome and in addition the symptom had deteriorated, and the electroconvulsive therapy (ECT) was administered. Though suxamethonium chloride is usually used as a muscular relaxant in the electroconvulsive therapy, we used vecuronium bromide (VCB) considering malignant syndrome. Maintenance of anesthesia was necessary because of the long effect of VCB. Anesthesia was induced and maintained by target controlled infusion (TCI) of propofol. Because propofol suppresses the convulsion, it is necessary to adjust the depth of anesthesia by propofol, and we used TCI of propofol. When the predicted blood propofol concentrations were 1.5 microg x ml(-1) and 2.0 microg x ml(-1), electric stimulation was given to the patient and enough seizure duration was obtained. TCI of propofol is useful for ECT to patients for whom suxamethonium chloride can not be used.
authors.affiliation: Department of Anesthesiology, Shiga University of Medical Science, Otsu 520-2192.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Imashuku
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Kojima
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Kuzukawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Nosaka
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D003863:Depression / Q000150:complications* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000150:complications* / Q000628:therapy*; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects; D015742:Propofol / Q000008:administration & dosage*; D014673:Vecuronium Bromide / Q000008:administration & dosage
chemical_list: D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D014673:Vecuronium Bromide; D015742:Propofol