Table 1 Summary of the consensus on the use of the approaches in difficult-to-induce-seizures electroconvulsive therapy cases according to the conditions
Procedures to be performed constantly | Mood disorder | Schizophrenia | Catatonia | High risk of cognitive dysfunction | High of cardiovascular events | |
|---|---|---|---|---|---|---|
Discontinuation of BZRA | 1st | 1st | 1st | 2nd | Best | 1st |
Reduction of BZRA | Best | Best | Best | 1st | Best | Best |
Use of flumazenil | 2nd | no consensus | no consensus | no consensus | no consensus | 2nd |
Premedication with xanthine derivatives | 3rd | 2nd | 2nd | 2nd | 2nd | 3rd |
Reduction or discontinuation of AED | Best | Best | Best | Best | Best | Best |
Use of APDs or ADDs with seizure-inducing effects | 2nd | 2nd | no consensus | 2nd | 2nd | 3rd |
Reduction of anesthetics | 1st | 1st | 1st | 1st | 1st | 1st |
Stimulation timing adjustment | 1st | 1st | 1st | 1st | 1st | 1st |
Switching from propofol to barbiturates | 2nd | 2nd | 2nd | 2nd | 2nd | 2nd |
Combination of remifentanil | 2nd | 2nd | 2nd | 2nd | 2nd | 2nd |
Use of ketamine | 2nd | 2nd | 2nd | 2nd | 2nd | 2nd |
Ensure hyperventilation | Best | Best | Best | Best | Best | Best |
Change pulse width | 2nd | 2nd | 2nd | 2nd | 2nd | 2nd |
Switching from BL to RUL | 2nd | 2nd | 2nd | 2nd | 1st | 2nd |