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e administration of remote location anesthesia, analsia, and sedation practices to pregnant patients has reased in recent years. Psychiatric disorders emerging or ccurring during pregnancy may cause severe problems Choosing an anesthetic agent that has no maternal or fetal toxic effects is important in remote location anesthesia for pregnant women. In terms of teratogenic risk, ECT use in pregnancy is considered relatively safe. Propofol and methohexital are commonly used anesthetic drugs for ECT. The teratogenic effects related to these drugs have not been specified.2 Propofol seems to be associated with some advantages in ECT practice, including lower rises in blood pressure and heart rate and faster postictal recovery in some measures.3 Succinylcholine is often used as a neuromuscular block during ECT.2 Succinylcholine is not transfered to any extent across the placenta, and has little effect on the fetus. The amount of succinylcholine that crosses the placental barrier depends on the concentration inclination between the maternal and fetal circulation; thus, repeated high doses both the woman and the fetus. Psychotropic drugs used the treatment of psychiatric disorders occurring during gnancy have side effects on the mothers and fetuses. e American Psychiatric Association (APA) practice guidees suggest electroconvulsive therapy (ECT) as a primary atment for major depression and bipolar disorder durpregnancy. ECT has been reported as a treatment with h efficacy and low risk for the management of these disers during all three trimesters of pregnancy as well as stpartum.1 These case studies report our experience administeranesthesia to four pregnant women with psychiatric orders who were scheduled for ECT treatment during gnancy. The women undergoing ECT treatment were diagnosed th bipolar disorder (two of them), atypical psychosis, d depression. All of the cases were evaluated by either obstetrician/gynecologist or an anesthesiologist the day fore treatment. The patients were monitored in the operng room with an electrocardiogram (ECG), a noninvasive od pressure monitor, and peripheral oxygen saturation O2). All of the patients were given oxygen by mask at 6 L/min. To prevent aspiration, all of the patients were en an H2-receptor antagonist 15--20 min before the produre and this was continued throughout the operation. ring the process, the fetal heart rates were constantly ntrolled with an ultrasound or doppler device by a senior stertics/gynecology assistant. The plasmacholinesterase els and other routine blood values of the patients were asured before the procedure. Propofol and Lystenon were d for anesthesia induction and maintenance in all cases mask ventilation with oxygen. The mean age of the tients was 28 (24--31) years, the mean gestational age was weeks (12--28), and the mean number of ECT applications s 10 (8--13). No maternal or fetal complications occurred rioperatively. All of the pregnant women gave birth at normal gestational age and the average Apgar score of newborns was between 8 and 10. No complications were served in the newborns during the one-month after birth or the presence of atypical pseudocholinesterase may lead to newborn apneas and muscle relaxation.4 In our cases, we used propofol as a hypnotic agent and succinylcholine as a neuromuscular block. All of the patients had unproblematic terminations to their pregnancies and the treatment did not have any adverse effects on the babies or the mothers.

Nossa experiência em anestesia durante terapia eletroconvulsiva em pacientes grávidas