Anesthesia procedures for electroconvulsive therapy with a focus on convulsive seizures

Abstract

The presence or absence of generalized seizures is assumed to be a major factor affecting the efficacy of electroconvulsive therapy (ECT). Not only patient factors but also psychiatric drugs have a great effect on the onset of generalized seizures. In addition, the anesthesia procedures and anesthetics, which are essential in nonconvulsive procedures, are also known to play roles in the onset of generalized seizures. Here we outline the influence of anesthesia procedures such as hyperventilation on convulsive seizures, as well as other influential factors, including the most frequently used anesthetics such as propofol and thiopental for ECT in Japan, combined use of intravenous remifentanil and dexmedetomidine, and ketamine anesthesia.