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Canadian Journal of Anaesthesia

, Volume 48, Issue 4, pp 405–408 | Cite as

Electroconvulsive therapy impairs systolic performance of the left ventricle

  • Yuji Kadoi
  • Shigeru Saito
  • Shinjiro Seki
  • Masanobu Ide
  • Toshihiro Morita
  • Fumio Goto
Cardiothoracic Anesthesia, Respiration and Airway

Abstract

Purpose: In this observational study, we examined left ventricular systolic performance during electroconvulsive therapy (ECT), using an echocardiographic automated border detection system.

Methods: Nine ASA I or II patients scheduled for ECT were studied. Bilateral ECT was performed after the administration of propofol 1 mg·kg−1, succinylcholine 1 mg·mg−1, and assisted mask ventilation with 100% oxygen. Cardiac function was monitored by transthoracic echocardiography, prior to anesthesia induction and throughout the ECT procedure until ten minutes after the seizure.

Results: Increased end-systolic area and decreased fractional area change were observed at one minute after the seizure compared to the awake condition. No regional wall motion abnormalities were observed in all patients both at baseline condition and during the ECT.

Conclusion: Systolic performance of the left ventricle estimated by echocardiography decreased transiently in the immediate period after the electric shock.

Keywords

Succinylcholine Esmolol Electroconvulsive Therapy Regional Wall Motion Abnormality Awake Condition 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif: Examiner, dans une étude par observation, la performance systolique du ventricule gauche pendant une sismothérqpie (ST) en utilisant un systèmen échographique de détection automatisée des limites pariétales.

Méthode: Neuf patients ASA I ou II devant subir une TEC ont été étudiés. La TEc bilatérale a été réalisée parès l’administration de 1 mg·kg−1 de propofol, 1 mg·kg−1 de succinylcholine et la ventilation assistée avec masque et 100 % d’oxygène. La fonction cardiaque a été évaluée par échocardiographe transthoracique, avant l’induction de l’anesthésie et tout au long de la TEC jusqu’à dix minutes après la période convulsive.

Résultats: L’augmentation de l’aire de fin de systole et la diminution de l’aire fractionnaire ont été observées une minute après la TEC en comparaison avec l’état vigile. Aucune anomalie régionale du mouvement de la paroi n’a été observée sous les conditions de base et pendant la TEC.

Conclusion: La performance systolique du ventricule gauche, estimée par l’échocardiographie, a diminué de façon transitoire dans la période suivant immédiatement l’électrochoc.

References

  1. 1.
    Selvin BL. Electroconvulsive therapy—1987. Anesthesiology 1987; 67: 367–85.PubMedCrossRefGoogle Scholar
  2. 2.
    Messina AG, Paranicas M, Katz B, Markowitz J, Yao F-S, Devereux RB. Effect of electroconvulsive therapy on the electrocardiogram and echocardiogram. Anesth Analg 1992; 75: 511–4.PubMedCrossRefGoogle Scholar
  3. 3.
    O’Connor CJ, Rothenberg DM, Soble JS, et al. The effect of esmolol pretreatment on the incidence of regional wall motion abnormalities during electroconvulsive therapy. Anesth Analg 1996; 82: 143–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Bednarz JE, Marcus RH, Lang RM. Technical guidelines for performing automated border detection studies. J Am Soc Echocardiogr 1995; 8: 293–305.PubMedCrossRefGoogle Scholar
  5. 5.
    Fredman B, d’Etienne J, Smith I, Husain MM, White PF. Anesthesia for electroconvulsive therapy: effects of propofol and methohexital on seizure activity and recovery. Anesth Analg 1994; 79: 75–9.PubMedGoogle Scholar
  6. 6.
    Mulier JP, Wouters PF, Van Aken H, Vermaut G, Vandermeersch E. Cardiodynamic effects of propofol in comparison with thiopental: assessment with a transesophageal echocardiographic approach. Anesth Analg 1991; 72: 28–35.PubMedCrossRefGoogle Scholar
  7. 7.
    Mayur PM, Shree RS, Gangadhar BN, Subbakrishna DK, Janakiramaiah N, Rao GSU. Atropine premedication and the cardiovascular response to electroconvulsive therapy. Br J Anaesth 1998; 81: 466–7.PubMedGoogle Scholar
  8. 8.
    Cahalan MK, Ionescu P, Melton HE, Adler S, Kee LL, Schiller NB. Automated real-time analysis of intraoperative transesophageal echocardiograms. Anesthesiology 1993; 78: 477–85.PubMedCrossRefGoogle Scholar
  9. 9.
    Hillel Z, Thys D. Monitoring left ventricular performance.In: Omoto R, Oka Y (Eds). Transesophageal Echocardiography. Tokyo: Shindan-to-Chiryo Co., Ltd, 2000: 57–70.Google Scholar

Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Yuji Kadoi
    • 1
  • Shigeru Saito
    • 1
  • Shinjiro Seki
    • 1
  • Masanobu Ide
    • 1
  • Toshihiro Morita
    • 1
  • Fumio Goto
    • 1
  1. 1.Department of Anesthesiology and ReanimatologyGunma University, School of MedicineGunmaJapan

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