Anesthesia in electroconvulsive therapy.

Electroconvulsive therapy (ECT) is an effective and life-saving method based on the generation of diffuse convulsions through a baseline electrical stimulus applied in severe depressions that do not respond to the pharmacological approach. There is no certain rule for decision of anesthetic method for ECT. However, general view is that a training anesthesist under the supervision of a specialist anesthesiologist should accompany the psychiatric team in this application. Fractures and dislocations resulting in trauma, respiratory problems and physiological responses during convulsions necessitated it to be performed under general anesthesia over time. The appropriate anesthesia management of ECT patients affects the therapeutic outcome of modern ECT. It is necessary to select induction agents according to the individual needs of the patient. Patients should be evaluated in terms of the problems they are associated with and the drugs they use, appropriate anesthesia should be selected, hemodynamics and oxygenation should be monitored. The cooperation of anesthesia and psychiatry doctors is important for the safe and effective ECT. In order for anesthetics to be defined as 'ideal', should provide a rapid induction and recovery, short duration of action, low side effects, and also should not reduce the efficacy of ECT. Since most of the anesthetics have anticonvulsant effect, they shorten the duration of convulsions depending on the dose. As can be seen there is a very critical balance between providing an ideal duration of convulsion and adequate depth of anesthesia. Adjuvant medications can be added when needed. Standardized hyperventilation techniques and anesthesia-ECT time interval (ASTI) should also be considered. Future research should standardize all these variables that guide clinical practice. Methohexital is the gold standard of short-acting barbiturates and is considered to be the 'gold standard' in the world, but it is not in our country