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Author: Thewarug Werawatganon
Publisher:
ISBN: 9789740307259
Category : Convulsions
Languages : en
Pages : 126
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Book Description
Objective: Electroconvulsive therapy is a treatment for psychiatric patients who fail medical treatment or have severe manifestation. Multiple monitored electroconvulsive therapy, stimulating more than one convulsion in one treatment session, ensures adequate stimulation and results in rapid response. Single dose of short acting muscle relaxant is sometimes inadequate for the later stimulation and results in too strong convulsion and injury. We compared succinylcholine dispensed in two divided doses with the usual single dose for modification of convulsion. Design: Randomized double blind crossover trial. Setting: Tertiary care public hospital. Participants: Forty adult psychiatric patients who required multiple monitored electroconvulsive therapy Intervention: After anesthetized, patients in conventional single dose regimen received 1 mg/kg succinylcholine before stimulation then two consecutive electrical stimuli were given in 3 minutes apart. Split dose regimen consisted of 0.75 mg/kg succinylcholine before first stimulation and 0.25 mg/kg before second stimulation. The wash out period was at least 48 hours before switching to another regimen in the next session. Main outcome measures: Isolated limb with tourniquet and compared the convulsion severity with another side to identify the poor modification of convulsion. Result: The incident of poor session in single dose regimen was 43.6% compared with 10.3% in split dose regimen (p = 0.006). The period effect, sequence effect and carryover effect was not demonstrated. The average time from the end of seizure to 20% muscle twitch height recovery in single dose and split dose were 125 seconds and 183 seconds respectively (p = 0.001). Conclusion: Split dose of succinylcholine is suitable for modification of seizure during multiple monitored electroconvulsive therapy, even though the muscle recovery may be a little bit longer.
Author: Thewarug Werawatganon
Publisher:
ISBN: 9789740307259
Category : Convulsions
Languages : en
Pages : 126
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Book Description
Objective: Electroconvulsive therapy is a treatment for psychiatric patients who fail medical treatment or have severe manifestation. Multiple monitored electroconvulsive therapy, stimulating more than one convulsion in one treatment session, ensures adequate stimulation and results in rapid response. Single dose of short acting muscle relaxant is sometimes inadequate for the later stimulation and results in too strong convulsion and injury. We compared succinylcholine dispensed in two divided doses with the usual single dose for modification of convulsion. Design: Randomized double blind crossover trial. Setting: Tertiary care public hospital. Participants: Forty adult psychiatric patients who required multiple monitored electroconvulsive therapy Intervention: After anesthetized, patients in conventional single dose regimen received 1 mg/kg succinylcholine before stimulation then two consecutive electrical stimuli were given in 3 minutes apart. Split dose regimen consisted of 0.75 mg/kg succinylcholine before first stimulation and 0.25 mg/kg before second stimulation. The wash out period was at least 48 hours before switching to another regimen in the next session. Main outcome measures: Isolated limb with tourniquet and compared the convulsion severity with another side to identify the poor modification of convulsion. Result: The incident of poor session in single dose regimen was 43.6% compared with 10.3% in split dose regimen (p = 0.006). The period effect, sequence effect and carryover effect was not demonstrated. The average time from the end of seizure to 20% muscle twitch height recovery in single dose and split dose were 125 seconds and 183 seconds respectively (p = 0.001). Conclusion: Split dose of succinylcholine is suitable for modification of seizure during multiple monitored electroconvulsive therapy, even though the muscle recovery may be a little bit longer.
Author: Charles H. Kellner
Publisher: Cambridge University Press
ISBN: 110840328X
Category : Medical
Languages : en
Pages : 131
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Book Description
This book is the need-to-know guide to the practice of modern electroconvulsive therapy.
Author: Charles H. Kellner
Publisher: Cambridge University Press
ISBN: 0521172551
Category : Medical
Languages : en
Pages : 159
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Book Description
An authoritative, concise, how-to guide to the various brain stimulation treatments used in psychiatry.
Author: Conrad M. Swartz
Publisher: Cambridge University Press
ISBN: 1139478869
Category : Medical
Languages : en
Pages : 619
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Book Description
Electroconvulsive therapy (ECT) is a psychiatric treatment involving the induction of a seizure through the transmission of electricity in the brain. Because of exploitation movies and greatly heightened drug company promotional activities ECT was used less frequently in the 1980s and 1990s. Eventually these movies were understood as unrealistic. Now these drugs are increasingly recognized as dangers to body health. Because of recent refinements and a far better scientific understanding of the clinical procedures and mechanisms underpinning ECT, this treatment modality has seen a resurgence in use and widespread appreciation of its safety. This book is the new definitive reference on electroconvulsive and neuromodulation therapies. It comprehensively covers the scientific basis and clinical practice of ECT as well as comparisons between ECT and medication therapies including the new generation of antipsychotic drugs. It also provides readers with administrative perspectives and specific details for the management of this modality in clinical practice. The new forms of nonconvulsive electrical and magnetic brain stimulation therapy are also covered in detail, in a separate section. The chapter authors are leading scholars and clinicians.
Author: American Psychiatric Association
Publisher: American Psychiatric Pub
ISBN: 1585627879
Category : Medical
Languages : en
Pages : 364
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Book Description
Since the development of pharmacoconvulsive therapy in 1934 and of electroconvulsive therapy (ECT) in 1938, ECT has proven far more valuable than just the intervention of last resort. In comparison with psychotropic medications, we now know that ECT can act more effectively and more rapidly, with substantial clinical improvement that is often seen after only a few treatments. This is especially true for severely ill patients -- those with severe major depression with psychotic features, acute mania with psychotic features, or catatonia. For patients who are physically debilitated, elderly, or pregnant, ECT is also safer than psychotropic medications. The findings of the American Psychiatric Association (APA) Task Force on ECT were published by the APA in 1990 as the first edition of The Practice of Electroconvulsive Therapy, inaugurating the development of ECT guidelines by groups both within the United States and internationally. Since then, advances in the use of this technically demanding treatment prompted the APA to mandate a second edition. The updated format of this second edition presents background information followed by a summary of applicable recommendations for each chapter. This close integration of the recommendations with their justifications makes the material easy to read, understand, and use. To further enhance usability, recommendations critical to the safe, effective delivery of treatment are marked with the designation "should" to distinguish them from recommendations that are advisable but nonessential (with the designations "encouraged," "suggested," "considered"). The updated content of this second edition, which spans indication for use of ECT, patient evaluation, side effects, concurrent medications, consent procedures (with sample consent forms and patient information booklet), staffing, treatment administration, monitoring of outcome, management of patients following ECT, and documentation, as well as education, and clinical privileging. This volume reflects not only the wide expertise of its contributors, but also involved solicitation of input from a variety of other sources, including applicable medical professional organizations, individual experts in relevant fields, regulatory bodies, and major lay mental health organizations. In addition, the bibliography of this second edition is based upon an exhaustive search of the clinical ECT literature over the past decade and contains more than four times the original number of citations. Complemented by extensive annotations and useful appendixes, this remarkably comprehensive yet practical overview will prove an invaluable resource for practitioners and trainees in psychiatry and related disciplines.
Author: J. John Mann
Publisher: Cambridge University Press
ISBN: 1107024633
Category : Medical
Languages : en
Pages : 429
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Book Description
Provides a one-stop evidence-based guide to the management of all types of mood disorders.
Author: Charles Vacanti
Publisher: Cambridge University Press
ISBN: 1139498401
Category : Medical
Languages : en
Pages : 1191
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Book Description
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
Author: Mayo Foundation for Medical Education
Publisher: Elsevier Health Sciences
ISBN: 0323567002
Category : Medical
Languages : en
Pages : 624
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Book Description
Authored by current and former physicians at the Mayo Clinic, Faust's Anesthesiology Review, 5th Edition, combines comprehensive coverage of essential anesthesiology knowledge with an easy-to-use format, reflecting the latest advances in the field. This outstanding review tool offers concise content on everything needed for certification, recertification, or as a refresher for anesthesiology practice, covering a broad range of important and timely topics. Save valuable time with this trusted resource as you master the latest advances, procedures, guidelines, and protocols in anesthesiology. Provides in-depth, yet succinct clinical synopses of all topic areas found on the ABA/ASA exam, with the perfect amount of information to ensure exam success. Contains 28 new chapters, including Blood Product Conservation, Tranexamic Acid Use in Orthopedic Surgery, Extracorporeal Membrane Oxygenation, Cardiovascular Opioids, Anesthesia for Patients with Rheumatoid Arthritis, Neurointerventional Anesthesiology, and the Perioperative Surgical Home. Features a new chapter on Sugammadex, the neuromuscular reversal drug that is changing anesthesia practice; a new chapter on Enhanced Recovery After Surgery (ERAS) protocols; and up-to-date information on opioid dependence.
Author: Mehul V. Mankad
Publisher: American Psychiatric Pub
ISBN: 1585628980
Category : Medical
Languages : en
Pages : 242
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Book Description
Increasingly, electroconvulsive therapy (ECT) is recognized as a proven, effective, and even life-saving intervention in certain mood and thought disorders when other treatments have had little or no effect. Despite the proven efficacy and safety of this standard treatment in psychiatry, its availability is variable. Part of this disparity in access is related to misunderstanding by laypersons regarding the treatment and its potential adverse effects. Adequate education and training of psychiatrists and their support staff are essential to ensuring patients' access to this vital treatment tool. The authors of Clinical Manual of Electroconvulsive Therapy offer this expansive yet reader-friendly volume to help psychiatrists successfully incorporate ECT into their clinical practices. It is also a valuable resource for medical students and psychiatric residents, as well as experienced clinicians and researchers. The book updates the 1985 original and 1998 second edition of Electroconvulsive Therapy: A Programmed Text, and provides readers with a scheduled approach to understanding the fundamental concepts of ECT while offering practical guidance for establishing and maintaining an ECT program. Topics include the history of ECT, indications for use, patient referral and evaluation, the basics of ECT, clinical applications, anesthetics and other medications, seizure monitoring and management, ictal motor and cardiovascular response, adverse effects, and maintenance ECT. Included are detailed descriptions of recent advances including ultra-brief pulse ECT, oxygenation, muscle relaxation, and other modifications that have made this very effective treatment much safer and more acceptable to patients. Currently, it is estimated that more than 100,000 people receive ECT treatments each year in the U.S. Indications for use of ECT are for mood disorders such as major depressive disorder and mania, and thought disorders including schizophrenia and schizoaffective disorder. Indications for use in other psychiatric disorders and general medical disorders such as Parkinson's disease, which appears to respond especially well to ECT, are reviewed as well. This highly-readable manual is a must-have for the library of any clinician interested in or currently practicing ECT: Provides background information on the origins of psychiatric treatments preceding ECT, including efforts using hydrotherapy and insulin comas Includes an algorithm for the management of ECT seizure adequacy Discusses contraindications as well as the potential adverse effects of ECT, including cognitive changes and cardiovascular complications Provides specific information about ECT device manufacturers, reprintable patient information sheets, and a written informed consent form This clinical manual comprehensively explores and explains the available knowledge regarding ECT -- based on extensive research over the past 70 years -- in order to help potential ECT clinicians make informed choices about the development and management of their ECT program.
Author: Albert J. Varon
Publisher: Cambridge University Press
ISBN: 1107602564
Category : Medical
Languages : en
Pages : 325
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Book Description
A concise review of the essential elements in the anesthetic care of the severely injured trauma patient.
