title: [Anesthetic management for electroconvulsive therapy in the patients with a history of neuroleptic malignant syndrome].
abstract: 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.
authors.affiliation: Department of Anesthesiology-Resuscitology, Yamaguchi University Graduate School of Medicine, Ube 755-8505.
authors.forename: Keiko
authors.initials: K
authors.lastname: Setoyama
authors.forename: Takao
authors.initials: T
authors.lastname: Hirata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Tsuruta
authors.forename: Mishiya
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Takefumi
authors.initials: T
authors.lastname: Sakabe
mesh_terms: 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*
chemical_list: D014150:Antipsychotic Agents