A Comparison of Techniques in Electro-Convulsive Therapy

1968 ◽  
Vol 114 (513) ◽  
pp. 989-996 ◽  
Author(s):  
Max Valentine ◽  
K. M. G. Keddie ◽  
David Dunne
Keyword(s):  
Electroconvulsive Therapy ◽  
Muscle Relaxants ◽  
Present Form ◽  
Convulsive Therapy ◽  
Intravenous Anaesthesia ◽  
Comparison Of Techniques ◽  
Electro Convulsive Therapy

Electroconvulsive therapy, modified by intravenous anaesthesia and muscle relaxants, has long been accepted as a satisfactory form of treatment. Relatively simple and safe, and effective in selected cases, the technique has undergone little change in recent years and seems almost in danger of becoming fixed indefinitely in its present form.

Electroconvulsive Therapy and Cognitive Improvement in a Very Elderly Depressed Patient

1987 ◽  
Vol 150 (2) ◽  
pp. 255-257 ◽  
Author(s):  
Brian O'Shea ◽  
Thomas Lynch ◽  
Jane Falvey ◽  
Gerald O'Mahoney
Keyword(s):  
Depressed Patient ◽  
Electroconvulsive Therapy ◽  
Paranoid Schizophrenia ◽  
Advanced Age ◽  
Computer Search ◽  
Very Elderly ◽  
Convulsive Therapy ◽  
Cognitive Improvement ◽  
Electro Convulsive Therapy ◽  
To Receive

A computer search of the literature revealed that the oldest documented patient to receive electro convulsive therapy (ECT) was a 94-year-old woman (Bernstein, 1972) who was diagnosed as having ‘anorexniearvosa’, but the history was suggestive of paranoid schizophrenia. She received a course of five ECTs and became much less paranoid, ate well, and put on weight. Her daughter lamented the fact that ECT had been deemed to be contra indicated 15years earlier on the grounds of advanced age.

The use of Arfonad for the Alleviation of Cardio-Vascular Stress Following Electro-Convulsive Therapy

1957 ◽  
Vol 103 (432) ◽  
pp. 636-644 ◽  
Author(s):  
G. I. Tewfik ◽  
B. G. Wells
Keyword(s):  
Muscle Relaxants ◽  
Positive Pressure ◽  
Convulsive Therapy ◽  
Pulmonary Lesions ◽  
Short Acting ◽  
Cardio Vascular ◽  
Electro Convulsive Therapy

The safety of electro-convulsive therapy (E.C.T.) has been greatly increased since muscle relaxants were first introduced for this purpose. Short-acting relaxants such as suxamethonium and suxethonium reduce the usual strong tonic and clonic contractions to faint muscle twitchings, and fractures do not occur. Respiration can be maintained throughout by positive pressure inflation so that cyanosis and stertorous breathing are avoided. This may ensure that material from small pulmonary lesions is not disseminated to other areas. It is disappointing that the cardiovascular commotion is only slightly reduced, and deaths still occur, albeit rarely.

Electroconvulsive Therapy and Depression

1965 ◽  
Vol 111 (477) ◽  
pp. 687-690 ◽  
Author(s):  
J. Mendels
Keyword(s):  
Electroconvulsive Therapy ◽  
Clinical Picture ◽  
Antidepressant Drugs ◽  
Convulsive Therapy ◽  
Depressed Patients ◽  
Treatment Of Depression ◽  
Electro Convulsive Therapy ◽  
Selection Of

After 25 years there is still considerable disagreement surrounding the indications for electro-convulsive therapy (E.C.T.). This is a particular problem in the treatment of depression, both because of the controversy over the division of depression into endogenous and reactive illnesses and because of the increasing use of the antidepressant drugs. These drugs will induce a remission in many patients, and will alter the clinical picture in others. As their use becomes still more widespread (Freyhan (1) has recommended that intensive imipramine treatment should be tried routinely before E.C.T. in all depressed patients) there may be further difficulties in the selection of depressed patients likely to respond well to E.C.T. Furthermore several recent reviews draw attention to a reduction in the use of E.C.T., and the lack of a consistent rationale for its use (2–4).

scholarly journals Midazolam-Flumazenil Topical Anaesthesia for Microlaryngoscopy with Jet Ventilation

1997 ◽  
Vol 25 (4) ◽  
pp. 358-364
Author(s):  
W. Rushatamukayanunt ◽  
T. Tritrakarn
Keyword(s):  
Treated Group ◽  
Muscle Relaxants ◽  
Total Intravenous Anaesthesia ◽  
Topical Anaesthesia ◽  
Parallel Study ◽  
Jet Ventilation ◽  
Double Blind ◽  
Intravenous Anaesthesia ◽  
Single Intravenous Injection ◽  
High Incidence

A comparison between midazolam and midazolam-flumazenil for total intravenous anaesthesia in combination with topical anaesthesia and muscle relaxants was performed in a double-blind, parallel study in 40 patients scheduled for microlaryngoscopy with or without bronchoscopic procedures using jet ventilation with oxygen. A single intravenous injection of midazolam 0.3 mg/kg, lignocaine spray and muscle relaxants provided adequate anaesthesia and good operative conditions throughout the procedures, which took 20 to 30 minutes. Patients who had placebo at the end of the procedures had a longer recovery and a high incidence of airway obstruction (20%). Administration of flumazenil provided prompt awakening in 19 of 20 patients (95%) within five minutes, resulting in rapid and favourable recovery without resedation or other side-effects, while only three of 20 (15%) patients in the placebo-treated group had improved consciousness within five minutes. The simplicity and reliability of the midazolam-flumazenil technique is attractive. We consider it worthy of further investigation for wider application in clinical practice.

When should ECT be used?

1977 ◽  
Vol 15 (1) ◽  
pp. 2-4
Keyword(s):  
Electroconvulsive Therapy ◽  
Mode Of Action ◽  
Depressive Illness ◽  
Muscle Relaxants ◽  
House Of Commons ◽  
Mode Of Administration ◽  
Lay People ◽  
Harmful Effects

Though electroconvulsive therapy (ECT) has been widely used in depressive illness for over 30 years, its use is empirical, its mode of action remains unknown, and some medical and lay people have asserted that its dangers outweigh its usefulness. Over the years the mode of administration has gradually changed with the introduction of anaesthetics and muscle relaxants. The number of shocks in a course of ECT has tended to lessen and unilateral ECT has some advantages.1 Nevertheless, recently the long-standing controversy on its use has increased. In some states in America legislation has been introduced to restrict it2 and questions on its possible harmful effects have been asked in the House of Commons.3

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