Background and Goal of Study:Modified electroconvulsive therapy (ECT) is an effective treatment for some psychiatric disorders and it is used globally. There is no standardized guidelines about anaesthesia for ECT and the European research in this area is scarce.1The purpose of this study was to analyse the ECT sessions over a two-year period at a Portuguese hospital and determine procedural complications and predictors associated with them. Materials and Methods:We retrospectively reviewed clinical records of all patients submitted to ECT from January 2015 to December 2016 at Postoperative Anaesthesia Care Unit (PACU) at our hospital.
Information collected was about demographics data, comorbidities, ASA status, ECT data, length of stay in PACU, medications administered, complications and their management. Descriptive statistics were performed and comparisons were made using chi-square test, T-test and Mann-Whitney U test. Statistical
significance was defined as p<0,05. Results and Discussion:We included 106 ECT sessions, which corresponded to 10 patients. Half of the patients were female, mean age was 55,6 ±3,1 years and all of them were classified as ASA III. Half of
them were unemployed or retired. Hypertension (90%) and dyslipidemia (80%) were the most common comorbidities. Major depression (80%) was the main psychiatric disorder founded. Each patient was submitted to a mean of 10,6±2,2 sessions. Median PACU stay was 80 minutes. In all sessions, propofol and suxamethonium were used. Complications occurred in 16 sessions: bradycardia(7), facial flush/ sweating(3), tachycardia(3), post-ECT seizure(1), agitation/disorientation(1) and bite of lips(1). We found statistical differences between the group of patients with and without complications: age(p=0,017), frequency of stimulus(p=0,009) and seizure duration(p=0,013). Although 15,1% of procedures had complications, all of them were solved spontaneously or with medication, they did not increase length of
stay in PACU (p=0,208) and there were no severe events, which confirms the safety of these sessions. Conclusions:Patients submitted to ECT who are more likely to have complications are older, have lower frequency of stimulus and have longer seizure duration. Anaesthesia for ECT can be managed with clinical surveillance, close monitoring and, if needed, additional medication. The occurrence of complications do not seem to interfere with patient's outcome.References:1.Uppal V.2010;10(6):192-6.

10 / Anaesthesia for electroconvulsive therapy: retrospective analysis over a two-year period at a Portuguese hospital