Introduction: Electroconvulsive therapy (ECT) is a critical procedure in psychiatric treatment, but as typically delivered involves the use of bag-mask ventilation (BMV), which during the COVID-19 pandemic exposes patients and treatment staff to potentially infectious aerosols. Objective: To demonstrate the utility of a modified anesthesia protocol for ECT utilizing preoxygenation by facemask and withholding the use of BMV for only those patients who desaturate during the apneic period. Methods: This chart review study analyzes patients who were treated with ECT using both the traditional and modified anesthesia protocols. Results: A total of 106 patients were analyzed, of whom 51 (48.1%) required BMV using the new protocol. Of clinical factors, only patient BMI was significantly associated with the requirement for BMV. Mean seizure duration reduced from 52.0 ± 22.4 to 46.6 ± 17.1 s, but seizure duration was adequate in all cases. No acute physical, respiratory, or psychiatric complications occurred during treatment. Conclusions: A modified anesthesia protocol reduces the use of BMV by more than 50%, while retaining adequate seizure duration.
Psychother Psychosom

中文翻译：

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修改后的电惊厥治疗麻醉方案允许减少 COVID-19 大流行期间产生气溶胶的面罩通气。


简介：电惊厥治疗 (ECT) 是精神科治疗中的一个关键程序，但通常涉及使用面罩通气 (BMV)，在 COVID-19 大流行期间，患者和治疗人员会暴露于潜在传染性气溶胶。目的：证明改进的 ECT 麻醉方案的实用性，该方案利用面罩预给氧，并仅对呼吸暂停期间去饱和的患者停止使用 BMV。方法：本图表回顾研究分析了使用传统麻醉方案和改良麻醉方案接受 ECT 治疗的患者。结果：总共分析了 106 例患者，其中 51 例（48.1%）需要使用新方案进行 BMV。在临床因素中，只有患者 BMI 与 BMV 需求显着相关。平均癫痫发作持续时间从 52.0 ± 22.4 秒减少到 46.6 ± 17.1 秒，但所有病例的癫痫发作持续时间都足够。治疗期间未发生急性身体、呼吸或精神并发症。结论：改进的麻醉方案可将 BMV 的使用量减少 50% 以上，同时保留足够的癫痫发作持续时间。
 心理医生