title: Complications of anesthesia during electroconvulsive therapy due to undiagnosed obstructive sleep apnea: A case-study.
abstract: This is a case description of two patients with bipolar affective disorder, who presented complications, possibly due to underlying, undiagnosed obstructive sleep apnea syndrome (OSAS), during anesthesia for electroconvulsive therapy (ECT). The first patient, just after receiving the second ECT, developed tachypnea with spasm of the upper airways and severe oxygen desaturation He was intubated and transferred to the medical intensive care unit where he was extubated 15 h later. The second patient, just after the eighth ECT, developed tachycardia and severe hypertension. He was transferred to the recovery room where he received oxygen therapy via nasal cannula and amlodipine. Both patients in the diagnostic polysomnographic tests which followed revealed a moderate to high apnea - hypopnea index (AHI) and distortion of sleep architecture. These cases highlight the need to assess for OSAS patients who receive ECT, especially if they exhibit peri-anesthesia complications.
authors.affiliation: Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece; Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Trakada
authors.affiliation: Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece.
authors.forename: Lemonia
authors.initials: L
authors.lastname: Velentza
authors.affiliation: Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Konsta
authors.affiliation: Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece; Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Athanasia
authors.initials: A
authors.lastname: Pataka
authors.affiliation: Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece; Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Dikeos
keywords: Anesthesia; Apnea – hypopnea index (AHI); Bipolar affective disorder; Electroconvulsive therapy (ECT); Obstructive sleep apnea syndrome (OSAS)