術中覚醒が判明した修正電気痙攣療法の1症例

Awareness during Anesthesia Revealed by Cancellation of Electrical Stimulation for Electroconvulsive Therapy：A Case Report

要旨

　電気痙攣療法では通電により直前の記憶が消失することが多い。筋弛緩薬投与後も覚醒していたことが通電を見合わせたことで明らかとなり，それまでの治療も浅麻酔下で行われていたことが疑われた症例を経験した。電気痙攣療法では，少なくとも初回は適切な麻酔深度が得られていることを確認することが重要である。

　A 25-year-old woman was undergoing electroconvulsive therapy for depression. During the fourth session, electrical stimulation was cancelled after the administration of succinylcholine because typical fasciculation was absent. Postoperatively, the patient reported awareness during anesthesia. During the next session, propofol was administered under electroencephalogram monitoring. The monitor demonstrated that the patient required high-dose propofol to achieve adequate sedation, suggesting that previous treatment had been performed under inadequate sedation. Adequate sedation should be carefully ascertained at the time of initiating treatment.