ABSTRACT
We experienced two cases of electroconvulsive therapy (ECT) through ambulatory surgery units. In case 1 patient was a 17 year old male with depressive disorder and the case 2 patient was a 64 year old male also with depressive disorder. A trial of various antidepressants had proved ineffective. They were treated with six ECTs for each case. The case 1 patient complained two times of myalgia suspected to be due to the adverse effects of succinylcholine administration and the case 2 patient showed tachycardia and hypertension due to sympathetic stimulation after application of the current, but the two cases were successfully cared for by ambulatory surgery unit and discharged without severe complications. Perioperative care for individuals who undergo outpatient ECT is similar to the care provided for scheduled ambulatory surgery. Successful performance of ambulatory ECT requires collaboration by psychiatrists, anesthesia care providers, skilled perioperative nurses, affected individuals, and family members.
Subject(s)
Adolescent , Humans , Male , Middle Aged , Ambulatory Surgical Procedures , Anesthesia , Antidepressive Agents , Cooperative Behavior , Depressive Disorder , Electroconvulsive Therapy , Hypertension , Myalgia , Outpatients , Perioperative Care , Psychiatry , Succinylcholine , TachycardiaABSTRACT
We report a case of acute cerebral infarction after general anesthesia. A 55-year-old man underwent total gastrectomy and splenectomy for advanced gastric cancer. Preoperatively, he has complained headache and dizziness for a year but neurologist, internist and anesthesiologist could not find any sign of cerebrovascular diseases. General anesthesia was induced with thiopental and maintained with 50% N2O and 1.5-2% enflurane in oxygen. After approximately 4h in the recovery room, he was not regained his consciousness. On physical examination, there was right hemiplegia. Immediate brain CT revealed acute cerebral infarction in left MCA and ACA territory. He was transported SICU. The following day he had a carotid Doppler ultrasonography that showed complete obstruction of both ICA. Neurologic examination showed negative eye reflex and pupil full dilation. He was discharged in a hopeless situation.