Impact of the anesthetic-to-electric stimulus time interval in patients undergoing electroconvulsive therapy

• Autor(a) principal: Inácio, Raquel Oliveira
• Data de Publicação: 2021
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.6/11411
• topic: Estímulo Elétrico; Indução Anestésica; Qualidade da Convulsão; Reorientação; Terapia Electroconvulsiva; Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina

Introduction: Drugs used for anesthesia in electroconvulsive therapy (ECT) have anticonvulsant properties that can affect seizure quality and duration. The anesthetic-toelectric stimulus time interval has been recently researched due its possible influence on treatment efficacy since it indirectly determines the brain concentration of anesthetic at the time of electric stimulation. In this study, we assessed the impact of the anesthetic-toelectric stimulus (ATES) time interval on EEG parameters and motor seizure duration, in patients undergoing ECT. Methods: This is an observational retrospective study, in which seizure quality parameters on EEG (duration, stereotypy, regularity, postictal suppression, and global quality) and seizure motor duration were previously recorded and then analyzed by a psychiatrist. Statistical analysis was performed with Linear Mixed Effects Models to assess the relationship between anesthetic-to-electric stimulus time interval on outcome variables, adjusting for potential confounding factors. Results: Forty-two patients and 490 ECT sessions were included in this study. A positive impact of a longer anesthetic-to-electric stimulus time interval was found in all EEG parameters (increased stereotypy, regularity, postictal suppression, and global seizure quality) and in motor seizure duration. Limitations: Besides possible data and operator bias inherent to the retrospective design, variables such as pretreatment ventilation and the effects of patient medication were not controlled. Conclusion: We demonstrated that longer anesthetic-to-electric stimulus time interval had a positive impact on ECT quality. Therefore, we defend a personalized procedure for determination of time intervals between anesthetic induction and muscle relaxant or electric stimulus for each patient.