Anesthetic management of modified electroconvulsive therapy for a patient with coronary aneurysms: a case report

Riho Nakayama; Takuya Yoshida; Norihiko Obata; Satoshi Mizobuchi

doi:10.1186/s40981-019-0298-y

Anesthetic management of modified electroconvulsive therapy for a patient with coronary aneurysms: a case report

JA Clin Rep. 2019 Nov 22;5(1):76. doi: 10.1186/s40981-019-0298-y.

Authors

Riho Nakayama¹, Takuya Yoshida², Norihiko Obata¹, Satoshi Mizobuchi¹

Affiliations

¹ Department of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, Hyogo, 650-0017, Japan.
² Department of Anesthesiology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe city, Hyogo, 650-0017, Japan. takuyayoshida47@gmail.com.

Abstract

Background: Modified electroconvulsive therapy (m-ECT) is utilized worldwide as an effective treatment for drug-resistant psychiatric disorders. However, during m-ECT, treatment of hypotension and hypertension in response to rapid hemodynamic changes is required. We used noninvasive continuous blood pressure monitoring system for continuous hemodynamic measurement during m-ECT.

Case presentation: The patient was a 77-year-old man with depression complicated by coronary artery aneurysms (CAAs). We managed general anesthesia during m-ECT by using the ClearSight™ system (Edwards Lifesciences Corp, Irvine, CA, USA) for hemodynamic measurement. As a result, we performed a total of 10 m-ECTs. No rupture of CAAs or myocardial ischemia occurred and depressive symptoms improved.

Conclusion: We successfully managed the anesthesia in m-ECT for a depressed patient with CAAs without complications by using the ClearSight™ system, which was used for the effective management of circulatory fluctuations.

Keywords: Anesthetic management; ClearSight™ system; Coronary artery aneurysm; Modified electroconvulsive therapy.