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Abstract
Discussion Forum (0)
Introduction:
Electroconvulsive therapy (ECT) is an evidenced-based treatment for severe depression and bipolar disorder in pregnancy. ECT involves induction of general anesthesia with muscle relaxation requiring positive pressure ventilation. Airway manipulation may lead to complications such as vocal cord injury, aspiration, inability to ventilate, and death. Appropriate airway management for ECT in pregnant patients is unknown. The purpose of this study was to determine if there are differences in incidence of airway complications (AWC) in subjects who underwent mask ventilation (MV) vs endotracheal intubation (ETI).
Methods:
This was a retrospective case-control study conducted from June 1, 2011 to June 30, 2020 of all adult pregnant patients who underwent anesthesia for ECT. Each ECT treatment on a pregnant patient was matched with two ECT treatments in non-pregnant control patients. Charts were queried for airway management (MV vs ETI), gestational age and AWCs. Each ECT procedure was considered an independent airway event.
Results:
13 non-pregnant and 11 pregnant patients met inclusion criteria and received 154 ECT treatments. 12 occurred in the 1st trimester, 44 in the 2nd trimester, and 20 in the 3rd trimester. In pregnant patients, airway management consisted of MV in 57 of the 76 treatments: 12 in the 1st trimester, 33 in the 2nd trimester and 8 in the 3rd trimester. No airway complications were experienced in pregnant or non-pregnant patients.
Conclusion/Implications:
There were no airway complications observed in pregnant patients undergoing either MV or ETI regardless of gestational age. Our data supports consideration of less invasive airway management during ECT of pregnant patients.
Electroconvulsive therapy (ECT) is an evidenced-based treatment for severe depression and bipolar disorder in pregnancy. ECT involves induction of general anesthesia with muscle relaxation requiring positive pressure ventilation. Airway manipulation may lead to complications such as vocal cord injury, aspiration, inability to ventilate, and death. Appropriate airway management for ECT in pregnant patients is unknown. The purpose of this study was to determine if there are differences in incidence of airway complications (AWC) in subjects who underwent mask ventilation (MV) vs endotracheal intubation (ETI).
Methods:
This was a retrospective case-control study conducted from June 1, 2011 to June 30, 2020 of all adult pregnant patients who underwent anesthesia for ECT. Each ECT treatment on a pregnant patient was matched with two ECT treatments in non-pregnant control patients. Charts were queried for airway management (MV vs ETI), gestational age and AWCs. Each ECT procedure was considered an independent airway event.
Results:
13 non-pregnant and 11 pregnant patients met inclusion criteria and received 154 ECT treatments. 12 occurred in the 1st trimester, 44 in the 2nd trimester, and 20 in the 3rd trimester. In pregnant patients, airway management consisted of MV in 57 of the 76 treatments: 12 in the 1st trimester, 33 in the 2nd trimester and 8 in the 3rd trimester. No airway complications were experienced in pregnant or non-pregnant patients.
Conclusion/Implications:
There were no airway complications observed in pregnant patients undergoing either MV or ETI regardless of gestational age. Our data supports consideration of less invasive airway management during ECT of pregnant patients.
Introduction:
Electroconvulsive therapy (ECT) is an evidenced-based treatment for severe depression and bipolar disorder in pregnancy. ECT involves induction of general anesthesia with muscle relaxation requiring positive pressure ventilation. Airway manipulation may lead to complications such as vocal cord injury, aspiration, inability to ventilate, and death. Appropriate airway management for ECT in pregnant patients is unknown. The purpose of this study was to determine if there are differences in incidence of airway complications (AWC) in subjects who underwent mask ventilation (MV) vs endotracheal intubation (ETI).
Methods:
This was a retrospective case-control study conducted from June 1, 2011 to June 30, 2020 of all adult pregnant patients who underwent anesthesia for ECT. Each ECT treatment on a pregnant patient was matched with two ECT treatments in non-pregnant control patients. Charts were queried for airway management (MV vs ETI), gestational age and AWCs. Each ECT procedure was considered an independent airway event.
Results:
13 non-pregnant and 11 pregnant patients met inclusion criteria and received 154 ECT treatments. 12 occurred in the 1st trimester, 44 in the 2nd trimester, and 20 in the 3rd trimester. In pregnant patients, airway management consisted of MV in 57 of the 76 treatments: 12 in the 1st trimester, 33 in the 2nd trimester and 8 in the 3rd trimester. No airway complications were experienced in pregnant or non-pregnant patients.
Conclusion/Implications:
There were no airway complications observed in pregnant patients undergoing either MV or ETI regardless of gestational age. Our data supports consideration of less invasive airway management during ECT of pregnant patients.
Electroconvulsive therapy (ECT) is an evidenced-based treatment for severe depression and bipolar disorder in pregnancy. ECT involves induction of general anesthesia with muscle relaxation requiring positive pressure ventilation. Airway manipulation may lead to complications such as vocal cord injury, aspiration, inability to ventilate, and death. Appropriate airway management for ECT in pregnant patients is unknown. The purpose of this study was to determine if there are differences in incidence of airway complications (AWC) in subjects who underwent mask ventilation (MV) vs endotracheal intubation (ETI).
Methods:
This was a retrospective case-control study conducted from June 1, 2011 to June 30, 2020 of all adult pregnant patients who underwent anesthesia for ECT. Each ECT treatment on a pregnant patient was matched with two ECT treatments in non-pregnant control patients. Charts were queried for airway management (MV vs ETI), gestational age and AWCs. Each ECT procedure was considered an independent airway event.
Results:
13 non-pregnant and 11 pregnant patients met inclusion criteria and received 154 ECT treatments. 12 occurred in the 1st trimester, 44 in the 2nd trimester, and 20 in the 3rd trimester. In pregnant patients, airway management consisted of MV in 57 of the 76 treatments: 12 in the 1st trimester, 33 in the 2nd trimester and 8 in the 3rd trimester. No airway complications were experienced in pregnant or non-pregnant patients.
Conclusion/Implications:
There were no airway complications observed in pregnant patients undergoing either MV or ETI regardless of gestational age. Our data supports consideration of less invasive airway management during ECT of pregnant patients.
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