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Biomedical subjects

K G Rasmussen

Publications and source records attributed to K G Rasmussen.

13 recordsLinked to original sources
PubMed2000

Electroconvulsive therapy for phantom limb pain.

Phantom limb pain is common in amputees. Although several treatments are available, a significant number of patients are refractory. Electroconvulsive therapy (ECT), which is usually given to patients with psychiatric disorders such as major depression, has shown efficacy in patients with a variety of pain syndromes occurring along with depression. Two patients are described herein with severe phantom limb pain refractory to multiple therapies, without concurrent psychiatric disorder, who received ECT. Both patients enjoyed substantial pain relief. In one case, phantom pain was still in remission 3.5 years after ECT. It is concluded that phantom limb patients who are refractory to multiple therapies may respond to ECT.

Aged↗
PubMed1999

Low-dose atropine in electroconvulsive therapy.

Anticholinergic medications such as atropine or glycopyrrolate have long been used in electroconvulsive therapy (ECT) to eliminate parasympathetically mediated dysrhythmias. However, such agents increase heart rate and myocardial workload and may increase risk of cardiac adverse events. What is needed is an intervention that is parasympatholytic without substantially increasing myocardial workload. In this study, a low dose of atropine was compared with placebo in ECT with attention to heart rate, blood pressure, cardiac rhythm, myocardial workload, and parasympathetic function. The dose of atropine that was used effectively blocked vagal tone with only a small and probably not clinically significant rise in myocardial workload for only a few minutes after the ECT seizure.

Adult↗
PubMed1999

Naloxone fails to prolong seizure length in ECT.

Electroconvulsive shock (ECS) in animals has been shown to enhance endogenous opiate systems. The anticonvulsant effects of ECS are also partially blocked by the opiate receptor antagonist naloxone, leading some investigators to postulate that the anticonvulsant effects of ECS are mediated by activation of endogenous opiates. If such a phenomenon occurs in humans, then naloxone might prolong seizure length in electroconvulsive therapy (ECT). In the present study, nine patients were given 2.0 mg intravenous (i.v.) naloxone 2 minutes prior to one-half of their ECT treatments. Motor seizure length was measured via the cuff technique. EEG tracings were read by an investigator blind to naloxone status. There was no difference between the two groups in either EEG or nonblindly evaluated motor seizure length. It is concluded that a dose of 2 mg naloxone does not effectively increase seizure length in ECT.

Adult↗
PubMed1997

Electroconvulsive therapy in patients with aortic stenosis.

Aortic stenosis confers an increased risk of complications during procedures with general anesthesia. There are no previously reported cases of electroconvulsive therapy (ECT) in patients with this valvular defect. Two cases are described of patients with moderate to severe aortic stenosis confirmed by echocardiography in whom courses of ECT resulted in clinical improvement without untoward cardiac complications. It is concluded that ECT can be safely given to patients with aortic stenosis in whom left ventricular function is normal.

Adrenergic beta-Antagonists↗
PubMed1996

Ketamine anesthesia in electroconvulsive therapy.

The use of ketamine anesthesia in electroconvulsive therapy (ECT) has been limited by its effects on blood pressure and concerns about untoward psychological reactions. However, because its effect on seizures is presumably less than that of methohexital, ketamine is listed as an alternative method to prolong seizure length. In this case series, 10 patients were given ketamine anesthesia during ECT. Whereas blood pressures were elevated above those seen with methohexital, seizure lengths actually decreased nonsignificantly with ketamine. There were no adverse psychological reactions noted with ketamine, which was generally well tolerated. It is concluded that ketamine anesthesia with the doses used in this series is unlikely to be associated with longer seizures in ECT. However, for theoretical reasons discussed, ketamine may be worth studying further in ECT.

Adult↗
PubMed1994

Possible impact of stimulus duration on seizure threshold in ECT.

Seizure thresholds were measured in patients treated with right unilateral electroconvulsive therapy (ECT) using 0.9 amp, 0.5 ms constant current pulses at 30 Hz for 0.93-2.8 s. Using these parameters, only two patients failed to seize at stimulus charges < or = 75.6 mC. Three patients were excluded from further analysis because they experienced generalized motor or electrographic seizures lasting less than 25 s and 30 s, respectively. The remaining 52 patients had a mean seizure threshold of 48.9 +/- 15.3 mC. Seizure threshold was correlated with age, but not sex. These values for seizure threshold are significantly lower than those reported previously using longer pulse-briefer train duration stimuli, suggesting that characteristics of the electrical stimulus influence seizure threshold. These findings have implications for electrical dosing in right unilateral ECT.

Adult↗
PubMed1994

Asystole in ECT.

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Depressive Disorder↗
PubMed1993

Electroconvulsive therapy in patients taking theophylline.

BACKGROUND: Initiating a course of electroconvulsive therapy (ECT) in patients taking theophylline has been associated with status epilepticus and consequent brain damage or even death. However, some patients with severe pulmonary conditions may both require theophylline and be seriously depressed enough to warrant ECT. Deciding whether to use ECT in such patients is a fairly common clinical problem. METHOD: The records of seven patients taking theophylline during nine courses of ECT were reviewed to ascertain whether inordinately long seizures occurred. RESULTS: In 77 documented seizures, there was one 190-second seizure as measured by EEG. All others were shorter than 100 seconds, and mean motor and EEG seizure lengths were comparable with those reported in the literature. CONCLUSION: Theophylline coadministration is a risk factor for prolonged seizures in patients starting a course of ECT. However, in most severely depressed, medication-refractory patients, a course of ECT can be undertaken with safety. Precautions that can decrease the risk of prolonged seizures are discussed.

Adult↗