05 October 2020>: Articles
Use of Nitrous Oxide to Facilitate Induction for Electroconvulsive Therapy: A Case Report
Unusual or unexpected effect of treatment
Kevin Lee B , Tanaya Sparkle B*DOI: 10.12659/AJCR.925883
Am J Case Rep 2020; 21:e925883
Table 1. Summary of the 12 ECT treatments over 29 days with clinical and anesthetic details. MECTA spectrum 5000 bilateral ECT settings for the stimulus for all of the patient’s ECT treatments were the following: pulse width 1.0 meter per s, frequency 60 hertz, duration 6.0 seconds, and amplitude 0.8 meters.
Rx No. | Day No. | Pre-procedure medications | Anesthetic | Paralytic | Static Imp. | Dynamic Imp. | Time of motor seizure | Time of EEG seizure | Pre ECT history from family |
---|---|---|---|---|---|---|---|---|---|
1 | 1 | None | Methohexital 60 mg | Succinylcholine 60 mg | 590 | 189 | 22 | 43 | Nonverbal, non-compliant, attempting to bite |
2 | 3 | Acetaminophen 650 mg | Methohexital 80 mg | Succinylcholine 80 mg | 620 | 179 | 22 | 37 | Nonverbal, eating and sleeping better |
3 | 5 | Acetaminophen 650 mg | NO, Methohexital 80 mg | Succinylcholine 80 mg | 516 | 181 | 16 | 28 | Spoke a full sentence but uncooperative with ADLs |
4 | 7 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 620 | 214 | 23 | 26 | Speaking in short sentences, Responds with gestures, gets out of bed, continues to stay uncooperative |
5 | 9 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 620 | 219 | 26 | 35 | Up and walking around, eating well, minimal verbal communication, positive facial expressions, no reported A/V hallucinations |
6 | 12 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 672 | 225 | 23 | 31 | More anxious and pacing around, broken sleep, eating well |
7 | 14 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 1420 | 197 | 27 | 48 | Mostly nonverbal, appetite remains well. Not sleeping well at night. Not incontinent anymore and uses the restroom |
8 | 19 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 550 | 170 | 16 | 22 | Spoke immediately after last Rx but decompensated to the point that she tried to run out of the house |
9 | 21 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | UK | UK | 26 | 47 | Incontinent again, nonverbal |
10 | 23 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 620 | 236 | 23 | 41 | Patient answering questions, talking to family, went grocery shopping with family |
11 | 25 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 700 | 222 | 22 | 32 | Attending social events, smiling and talking to people, less anxious, following commands to assist with exam |
12 | 29 | Acetaminophen 650 mg | NO, Etomidate 16 mg | Succinylcholine 80 mg | 530 | 200 | 15 | 32 |