[Anesthetic management for electroconvulsive therapy in the patients with a history of neuroleptic malignant syndrome].
We report three patients with a history of neuroleptic malignant syndrome for whom modified electroconvulsive therapy (m-ECT) was scheduled. Two patients suffered from schizophrenia, and one suffered from depression. Their symptoms, such as hyperthermia, consciousness disturbance, myotonus, tremor, sweating, and tachycardia, improved gradually with administration of dantrolene and fluid infusion. However, their psychotic state was exacerbated. Therefore, m-ECT was scheduled. When patients were restless at the hospital ward, they were sedated with propofol and transferred to the operating room. General anesthesia was induced with thiopental 2.5-5 mg x kg(-1). After loss of consciousness, vecuronium bromide 0.01 mg x kg(-1) followed by a dose of 0.1 mg x kg(-1) was administered and ventilation was assisted using a face mask and 100% oxygen. After the ECT stimulus, the patients were sedated with propofol until full recovery from muscle relaxation. Although anesthesia time (mean 38 min) was slightly longer (19 min) than in those anesthetized with thiopental and suxamethonium chloride, m-ECT was performed safely and effectively.
Setoyama
Keiko
K
Department of Anesthesiology-Resuscitology, Yamaguchi University Graduate School of Medicine, Ube 755-8505.
Hirata
Takao
T
Saeki
Hitoshi
H
Morimoto
Yasuhiro
Y
Tsuruta
Syunsuke
S
Matsumoto
Mishiya
M
Sakabe
Takefumi
T
D000293:Adolescent; D000768:Anesthesia, General; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003863:Depression / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology*; D012559:Schizophrenia / Q000628:therapy*
D014150:Antipsychotic Agents