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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 medicationsAnestheticParalyticStatic Imp.Dynamic Imp.Time of motor seizureTime of EEG seizurePre ECT history from family
11NoneMethohexital 60 mgSuccinylcholine 60 mg5901892243Nonverbal, non-compliant, attempting to bite
23Acetaminophen 650 mgMethohexital 80 mgSuccinylcholine 80 mg6201792237Nonverbal, eating and sleeping better
35Acetaminophen 650 mgNO, Methohexital 80 mgSuccinylcholine 80 mg5161811628Spoke a full sentence but uncooperative with ADLs
47Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg6202142326Speaking in short sentences, Responds with gestures, gets out of bed, continues to stay uncooperative
59Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg6202192635Up and walking around, eating well, minimal verbal communication, positive facial expressions, no reported A/V hallucinations
612Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg6722252331More anxious and pacing around, broken sleep, eating well
714Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg14201972748Mostly nonverbal, appetite remains well. Not sleeping well at night. Not incontinent anymore and uses the restroom
819Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg5501701622Spoke immediately after last Rx but decompensated to the point that she tried to run out of the house
921Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mgUKUK2647Incontinent again, nonverbal
1023Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg6202362341Patient answering questions, talking to family, went grocery shopping with family
1125Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg7002222232Attending social events, smiling and talking to people, less anxious, following commands to assist with exam
1229Acetaminophen 650 mgNO, Etomidate 16 mgSuccinylcholine 80 mg5302001532

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923