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ID 118832
Author
Mutoh, Sarara Tokushima University
Maeda, Yuki Tokushima University
Keywords
augmentation
alternative anesthetic
electroconvulsive therapy
ketamine
seizure duration
Content Type
Journal Article
Description
Objective:
Electroconvulsive therapy (ECT) is highly effective for severe psychiatric disorders; however, short seizure durations may lead to ineffective therapy. This retrospective study aimed to examine the risks and benefits of switching to ketamine anesthesia to augment seizure durations during an acute course of ECT.
Methods:
We included 33 patients who underwent ketamine anesthesia due to suboptimal seizures during an acute course of ECT. We assessed seizure duration, stimulus dose, hemodynamic variability, and post-seizure complications before and after switching to ketamine.
Results:
Age was significantly associated with suboptimal seizures during ECT (p = 0.040). After switching to ketamine, 32 patients (97%) experienced prolonged seizure duration. Ketamine significantly prolonged both electroencephalogram and motor seizure durations with a mean difference of 34.6 s (95% CI, 26.4 to 42.7; p < 0.001) and 26.6 s (95% CI, 19.6 to 33.6; p < 0.001), respectively. It also significantly reduced stimulus dose (mean difference: −209.5 mC [95% CI, −244.9 to −174.1], p < 0.001). Additionally, maximum changes in systolic blood pressure and heart rate during ECT sessions significantly increased with ketamine (mean difference: 27.2 mmHg [95% CI, 12.0 to 42.4; p = 0.001]; 25.7 bpm [95% CI, 14.5 to 36.8; p < 0.001], respectively). Patients reported more headaches with ketamine (p = 0.041).
Conclusions:
Our results provide evidence that ketamine as an alternative anesthetic can augment seizure durations in specific patients experiencing suboptimal seizures during an acute course of ECT. However, its use requires greater attention to circulatory management and post-seizure complications.
Journal Title
​The Journal of ECT
ISSN
10950680
15334112
NCID
AA11221663
AA12556055
Publisher
Wolters Kluwer Health
Published Date
2023-12-08
Remark
論文本文は2024-12-08以降公開予定
Rights
This is a pre-copyedited, author-produced version of an article accepted for publication in The Journal of ECT. The published version of record Mutoh, Sarara MD; Kinoshita, Michiko MD, PhD; Maeda, Yuki MD; Tanaka, Katsuya MD, PhD . Ketamine as an Alternative Anesthetic for Augmenting Seizure Durations During Electroconvulsive Therapy: A Retrospective Observational Study. The Journal of ECT 40(2): p134-139:10.1097/YCT.0000000000000981, December 8, 2023. is available online at: https://doi.org/10.1097/YCT.0000000000000981.
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
language
eng
TextVersion
その他
departments
University Hospital
Medical Sciences