General anaesthesia protocols for patients undergoing electroconvulsive therapy: Retrospective analysis of 504 sessions over a five-year period at a tertiary care hospital in Oman

Objectives: This study aimed to review general anaesthesia protocols for patients undergoing electroconvulsive therapy [ECT] at a tertiary care hospital in Oman, particularly with regards to clinical profile, potential drug interactions and patient outcomes

Methods: This retrospective study took place at the Sultan Qaboos University Hospital [SQUH], Muscat, Oman. The electronic medical records of patients undergoing ECT at SQUH between January 2010 and December 2014 were reviewed for demographic characteristics and therapy details

Results: A total of 504 modified ECT sessions were performed on 57 patients during the study period. All of the patients underwent a uniform general anaesthetic regimen consisting of propofol and succinylcholine; however, they received different doses between sessions, as determined by the treating anaesthesiologist. Variations in drug doses between sessions in the same patient could not be attributed to any particular factor. Self-limiting tachycardia and hypertension were periprocedural complications noted among all patients. One patient developed aspiration pneumonitis [1.8%]

Conclusion: All patients undergoing ECT received a general anaesthetic regimen including propofol and succinylcholine. However, the interplay of anaesthetic drugs with ECT efficacy could not be established due to a lack of comprehensive data, particularly with respect to seizure duration. In addition, the impact of concurrent antipsychotic therapy on anaesthetic dose and subsequent complications could not be determined

Adult sickle cell disease a five-year experience of intensive care management in a university hospital in Oman

Sickle cell disease [SCD] is an inherited disease caused by an abnormal type of haemoglobin. It is one of the most common genetic blood disorders in the Gulf area, including Oman. It may be associated with complications requiring intensive care unit [ICU] admission. This study investigated the causes of ICU admission for SCD patients. This was a retrospective analysis of all adult patients >/= 12 years old with SCD admitted to Sultan Qaboos University Hospital [SQUH] ICU between 1st January 2005 and 31st December 2009. A total number of 49 sickle cell patients were admitted 56 times to ICU. The reasons for admission were acute chest syndrome [69.6%], painful crises [16.1%], multi-organ failure [7.1%] and others [7.2%]. The mortality for SCD patients in our ICU was 16.1%. The haemoglobin [Hb] and Hb S levels at time of ICU admission were studied as predictors of mortality and neither showed statistical significance by Student's t-test. The odds ratio, with 95% confidence intervals, was used to study other six organ supportive measures as predictors of mortality. The need for inotropic support and mechanical ventilation was a good predictor of mortality. While the need for non-invasive ventilation, haemofiltration, blood transfusions and exchange transfusions were not significant predictors of mortality. Acute chest syndrome is the main cause of ICU admission in SCD patient. Unlike other supportive measures, the use of inotropic support and/or mechanical ventilation is an indicator of high mortality rate SCD patient