Use of transnasal humidified rapid-insufflation ventilatory exchange in Electroconvulsive therapy, a tool to increase patient safety in a remote area: A case series

• Published in: Trends in anaesthesia & critical care 2019-10, Vol.28, p.36-38
• Main Author: Land, Gabriela Maria Rivas
• Format: Article
• Language: English
• ISSN: 2210-8440
• DOI: 10.1016/j.tacc.2019.06.003

Electroconvulsive therapy (ECT) remains a mainstay treatment option in psychiatry. In England, approximately 2240 treatments are administered annually. The anaesthetic requirements for the procedure include the control of haemodynamic changes, related complications, hypoventilation, hypoxia and hypercarbia due to an extended period of apnoea, amnesia and muscle relaxation. Transnasal humidified rapid-insufflation ventilator exchange (THRIVE), may offer a novel method of ventilation/oxygenation in the presence of apnea that makes the procedure safer especially when this is done outside main theatres. Four sessions of Electroconvulsive therapy were conducted; in total 8 patients for ECT and 15 treatments applied during the period of the case series. All patients received general anaesthesia with an induction agent and muscle relaxant. The patients were oxygenated/ventilated with the use of THRIVE. No desaturation was present in any of the 15 treatments during or after the procedure. None of the patients reported any discomfort during the preoxygenation period with THRIVE. Introducin ukg THRIVE to the Electroconvulsive therapy suite as a unique airway technique maintained adequate oxygen saturation airway patency during the period of apnoea in patients paralyzed. THRIVE also gives an alternative for oxygenation in high risk patients in the ECT suite remote to main theatres.