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Combination of Electroconvulsive Therapy With Skin Graft Surgery for a Schizophrenic Patient With Burns

Iwata, Ken MD, PhD*; Masuda, Michiko MD†; Soejima, Kazutaka MD, PhD†; Ohashi, Miyuki MD‡

doi: 10.1097/YCT.0b013e31819140e1
Case Reports

We report on the use of electroconvulsive therapy (ECT) on a patient with schizophrenia immediately after skin graft surgery for extensive burns. The patient was 22 years old and had been burned in more than 33% of his body because of a suicide attempt. After his admission to a burn unit, he continued to make repeated suicide attempts. Electroconvulsive therapy with a muscle relaxant and intubation was administered after scheduled skin graft surgery. His hallucinations diminished after a series of ECT treatments, and his behavior improved. This combination avoids an anesthetic procedure and makes it possible for physicians to administer ECT earlier for burned psychopharmacological treatment-resistant psychiatric patients. The combination treats a patient's physical and mental illnesses simultaneously.

From the *Departments of Neuropsychiatry, †Plastic Surgery, and ‡Anesthesiology, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japan.

Received for publication September 28, 2008; accepted October 13, 2008.

Reprints: Ken Iwata, MD, PhD, Department of Neuropsychiatry, Tokyo Metropolitan Hiroo General Hospital, 2-34-10, Ebisu, Shibuya-ku, Tokyo 150-0013, Japan (e-mail: keniwata@hiroo-hospital.metro.tokyo.jp).

Conflict of Interest Statement: Authors of this paper do not have any significant relation with or financial interest in a company (or its competitor) that makes a product discussed in the paper.

© 2009 Lippincott Williams & Wilkins, Inc.