Hoʻoikaika electroconvulsive

Hoʻohana ka electroconvulsive therapy (ECT) i kahi au uila e mālama i ke kaumaha a me nā maʻi noʻonoʻo ʻē aʻe.

I ka wā o ECT, hoʻonāukiuki ka uila i ka hopu ʻana i ka lolo. Manaʻo nā kauka he hiki i ka hana hopu ke kōkua i ka lolo "rewire" iā ia iho, kahi e kōkua ai e hōʻoluʻolu i nā ʻōuli. Maluhia a maikaʻi ʻole ʻo ECT.

Hana pinepine ʻia ʻo ECT i ka haukapila ʻoiai ʻoe e hiamoe ana a ʻaʻohe ʻeha (general anesthesia):

• Loaʻa iā ʻoe ka lāʻau e hōʻoluʻolu ai iā ʻoe (relaxant muscle). Loaʻa iā ʻoe kekahi lāʻau ʻē aʻe (anesthetic hana pōkole) e hoʻokau iā ʻoe i ka wā pōkole e hiamoe a pale iā ʻoe mai ka ʻehaʻeha.
• Kau ʻia nā uila i kou poʻo. Mālama nā uila ʻelua i kāu hana lolo. Hoʻohana ʻia kekahi mau uila ʻelua no ka lawe ʻana i ke au uila.
• Ke hiamoe ʻoe, hāʻawi ʻia i kahi poʻo liʻiliʻi o ka uila i kou poʻo e hana i ka hopu ʻana i ka lolo. Loaʻa ia ma kahi o 40 kekona. Loaʻa iā ʻoe ka lāʻau e pale ai i ka hopu ʻana mai ka laha ʻana i kou kino. ʻO ka hopena, neʻe iki kou mau lima a wāwae paha i ka wā o ke kaʻina hana.
• Hāʻawi pinepine ʻia ʻo ECT i hoʻokahi manawa i kēlā me kēia 2 a 5 mau lā no ka nui o 6 a 12 mau kau. I kekahi manawa pono hou nā kau.
• He mau minuke ma hope o ka lapaʻau ʻana, ala ʻoe. ʻAʻole ʻoe e hoʻomanaʻo i ka lāʻau. Lawe ʻia ʻoe i kahi e ola ai. Ma laila, ke kiaʻi nei ka hui mālama ola iā ʻoe. Ke ola ʻoe, hiki iā ʻoe ke hoʻi i ka home.
• Pono ʻoe e hoʻokele i kahi mākua iā ʻoe i ka home. E mālama pono i kēia ma mua o ka manawa.

He lāʻau lapaʻau maikaʻi loa ʻo ECT no ke kaumaha, ʻo ke kaumaha nui loa. Hiki ke kōkua nui no ka mālama ʻana i ke kaumaha i ka poʻe nāna:

• Loaʻa nā kuhi hewa a i ʻole nā ​​hōʻailona psychotic me kā lākou kaumaha
• Hāpai a kaumaha loa
• He suicidal
• ʻAʻole hiki ke lawe i nā lāʻau antidepressant
• ʻAʻole i pane piha i nā lāʻau antidepressant

ʻO ka liʻiliʻi pinepine, hoʻohana ʻia ʻo ECT no nā kūlana e like me mania, catatonia, a me psychosis e hoʻomaikaʻi maikaʻi ʻole ʻia me nā ʻano lāʻau ʻē aʻe.

Ua loaʻa i ka ECT kaomi maikaʻi ʻole, ma ka ʻāpana ma muli o kona hiki no ka pilikia ʻana i ka hoʻomanaʻo. Mai ka manawa i hoʻolauna ʻia ʻo ECT i ka makahiki 1930, ua hoʻemi nui ʻia ka mahele o ka uila i hoʻohana ʻia i ke kaʻina hana. Ua hoʻemi loa kēia i nā hopena o kēia kaʻina hana, me ka nalo ʻana o ka hoʻomanaʻo.

Eia nō naʻe, hiki i ka ECT ke hana i nā hopena ʻaoʻao, me:

• Huikau ka mea mau o ka manawa pōkole wale nō
• ʻEha poʻo
• Ke koko haʻahaʻa (hypotension) a i ʻole ke kiʻekiʻe o ke koko (hypertension)
• Ka nalo ʻana o ka hoʻomanaʻo (ʻo ka hoʻomanaʻo paʻa mau ʻana ma ʻō aku o ka manawa o ke kaʻina hana ʻoi aku ka liʻiliʻi ma mua o ka wā ma mua)
• ʻEha ka ʻili
• Nusea
• Kuʻi puʻuwai wikiwiki (tachycardia) a i ʻole nā ​​pilikia puʻuwai ʻē aʻe

Hoʻonohonoho kekahi mau kūlana olakino i ka poʻe i ka makaʻu nui no nā hopena ʻaoʻao mai ka ECT. E kūkākūkā i kāu kūlana olakino a me nā mea e hopohopo ai me kāu kauka ke hoʻoholo nei inā kūpono ʻo ECT nāu.

Ma muli o ka hoʻohana ʻia ʻana o ka anesthesia ākea no kēia kaʻina hana, e noi ʻia ʻoe ʻaʻole e ʻai a inu paha ma mua o ka ECT.

E noi i kāu mea lawelawe inā pono ʻoe e lawe i nā lāʻau i kēlā me kēia lā i ke kakahiaka ma mua o ECT.

Ma hope o kahi papa maikaʻi o ECT, e loaʻa iā ʻoe nā lāʻau a i ʻole emi pinepine ka ECT e hōʻemi i ka makaʻi o kahi ʻeha kaumaha ʻē aʻe.

Hōʻike kekahi poʻe i ka huikau mālie a me ka ʻeha o ke poʻo ma hope o ECT. Pono e mau kēia mau ʻōuli no kekahi manawa pōkole.

Lapaʻau hoʻohuli; Pākuʻi hoʻohuli; ECT; Kaumaha - ECT; ʻO Bipolar - ECT

Hermida AP, Aniani OM, Shafi H, McDonald WM. ʻO ka electroconvulsive therapy i ke kaumaha: ka hana o kēia manawa a me ke alakaʻi e hiki mai ana. ʻO Psychiatr Clin ʻAkau ʻAkau. 2018; 41 (3): 341-353. PMID: 30098649 pubmed.ncbi.nlm.nih.gov/30098649/.

Perugi G, Medda P, Barbuti M, Novi M, Tripodi B. Ke kuleana o ka electroconvulsive therapy i ka mālama ʻana i ka mokuʻāina hui bipolar koʻikoʻi. ʻO Psychiatr Clin ʻAkau ʻAkau. 2020; 43 (1): 187-197. PMID: 32008684 pubmed.ncbi.nlm.nih.gov/32008684/.

Siu AL; ʻO ka Hana Hana Hana Hana US (USPSTF), Bibbins-Domingo K, et al. ʻO ka loiloi no ke kaumaha i nā mākua: ʻO ka ʻōlelo aʻoaʻo a ka US Preventive Services Task Force. JAMA. 2016; 315 (4): 380-387. PMID: 26813211 pubmed.ncbi.nlm.nih.gov/26813211/.

Welch CA. Hoʻoikaika electroconvulsive. I: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. ʻO ka haukapila laulima ʻo Massachusetts General Hospital. ʻElua ed. Piladelapia, PA: Elsevier; 2016: chap 45.