E Tecoult | PubMed Health

PubMed2001

Morbidity in electroconvulsive therapy.

BACKGROUND AND OBJECTIVE: To assess retrospectively the complications and morbidity of electroconvulsive therapy. METHODS: Complications occurring in 75 patients during 612 electroconvulsive therapy procedures under propofol anaesthesia were reviewed by data analysis. RESULTS: At least one complication occurred in 51 patients (68%) during the course of their treatment. Among these complications, 12 were potentially life-threatening: one patient developed angina pectoris, another aspiration pneumopathy, there were two incidences of bronchospasm, three hypoxic episodes (SpO2 < 92% with FiO2=1) and five severe episodes of laryngospasm which caused hypoxia. Twenty-five patients (33%) were confused for more than 2 h after the electroconvulsive therapy. Confusion recurred in 10 patients (13%) after several sessions of electroconvulsive treatment. Six patients had a traumatic complication, with one requiring surgery. CONCLUSION: Our results, compared with other studies, suggest that electroconvulsive therapy is not a low-risk procedure, with a particularly high rate of respiratory complications that may have been previously overlooked. Therefore, ambulatory anaesthesia may not be appropriate on a regular basis for most of these patients.

Adult↗

PubMed2000

Influence of anesthesia protocol in experimental traumatic brain injury.

Most pharmacologic studies on brain trauma in animals are performed while the animals are under general anesthesia, which can interfere with brain metabolism and modify the experimental results. This study investigates the effects of three anesthetic drugs (halothane 2% and 4%, propofol at 10 mg/kg, and chloral hydrate at 400 mg/kg) on the traumatic brain injury-induced neurologic deficit in mice. Trauma was induced with a weight-drop device. For each drug, animals were divided into four groups; the first did not receive either anesthesia or trauma, the second received anesthesia but no trauma, the third received a trauma without anesthesia, and the fourth received anesthesia before the trauma. A neurologic examination using two different scorings (string and grip test) was performed 1 hour and 24 hours after the trauma. Mortality after trauma was increased for halothane 4% (48% versus 20% in unanesthetized mice), propofol (80% versus 30%), and chloral hydrate (70% versus 44%). Halothane 2% did not increase the mortality in traumatized mice. Halothane 2% or 4% anesthesia did not modify the string score after the trauma. Grip score after the trauma was better in mice anesthetized with halothane at either 2% or 4%. Mice injured under anesthesia with chloral hydrate had worse grip and string scores (P < .05) than unanesthetized mice. These results lead us to question the influence of anesthesia on the results obtained in experimental neuropharmacologic studies, particularly when there are discrepancies between two studies on the same pharmacologic treatment, which differ in their anesthesia protocols.

Anesthesia↗