Elektro Convulsive Therapi Edt ( Ect )

7/23/2019 Elektro Convulsive Therapi Edt ( Ect )

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RB_j mam 1

ELEKTRO CONVULSIVE

THERAPI ( ECT )TERAPI KEJANG LISTRIK

Oleh : dr.H. Ahmadi NH.



RB_j mam 2

Perkema!"a! La#l$ V$! %ed&!a ( '* ) + Cam,$r I% da! Pe!-l e!-e-ra#$l (%e-ra#$l) IV

"e/ala Ski#$0re!ia erk&ra!". U"$ Cerli-i da! L&1i$i!i ( '2 ) + alira! li3-rik ke/a!"4 ,e!""a!-i -era,i

3eel&m!a + %a3alah: k$m,re3i 5er-era 67 84 di3l$ka3i 3e!di ek3-remi-a3 '9 84 0rak-&r 8. Araham E ;e!!e--4 ,3ikia-er ( '6' ) + K&rare4 a!e3-e3i 3,i!al4 ,arali3i3 $-$-4 me!"&ra!"i

ke/a!" da! 0rak-&r + S&11i!l 1h$li!e ( a!e1-e!e )4 m&3kle relak3a!-4

me!"&ra!"i k$!-rak3i $-$- da! e0ek 3am,i!" lai!



RB_j mam 3

%eka!i3me ker/a Te$ri Ne&r$0i3i$l$"i:

+ 3elama ke/a!": alira! darah 3ereral4 ,emakaia!"l&k$3e4 $k3i"e! da! ,ermeaili-a3 3a<ar darah $-akme!i!"ka-

+ 3e-elah ke/a!": alira! darah 3ereral da!

me-a$li3me "l&k$3e me!&r&! + dera/ad ,e!&r&!a! me-a$li3me 3ereralerh&&!"a! d" re3,$! -era,e&-ik.

Te$ri Ne&r$kimia<i:

+ ECT mem,e!"ar&hi ,er&aha! 3i3-em !e&r$!alm&3kari!ik4 k$li!er"ik da! d$,ami!er"ik+ ECT me!i!"ka-ka! re3e,-$r 3er$-$!er"ik ,a31a

3i!a,-ik+

%em,eraiki k$!di3i ""! /i<a " ada.



RB_j mam 4

I!dika3i =e,re3i era-4 ma!ia4 ""! i,$lar P3ik$3i3 ak&-4 3ki# ka-a-$! da! -i,e lai! G"! ,ara!$id4 1ema3 hea-4 $3e3i0 k$m,&l3i0 Hi3-eri k$!5er3i4 deliri&m -reme!34 e,ile,3i

,3ik$m$-$r4 dll.



RB_j mam 5

K$!-ra i!dika3i: A3$l&-:

-&m$r 3ereri da! TIK me!i!"ka-4 m$kard

i!0ark4 -1 ka5er!e4 0rak-&r. Rela-i0:

i!0ek3i>,erada!"a!4 -1 -a!,a ka5er!e4

<a!i-a hamil4 ""! kardi$ 5a3k&ler4 hi,er-e!3i4e,ile,3i4 $3-e$mieli-i34 $3-e$,$r$3i34-ir$-$k3ik$3i3 d" ek3$0-alm&34 $m,4"l$mer&l$!e0ri-i3.



RB_j mam 6

ECT KONVENSIONAL Ala-4 k$!5&l3a-$r -i,e ? &-k ,$likli!ik da!

-i,e 799 &-k a!"3al. =ile!"ka,i de!"a!:

Pe!"a-&r -eka!a! li3-rik (5$l-a3e) '77+'675$l-. Pe!"-a-&r <ak-& $-$ma-i3: 74+746 a-a& +

de-ik Elek-r$de4 di,a3a!" i0r$!-$-em,$rali3 i!1i

dia-a3 ,er-e!"aha! 3&d&- ma-a d" -eli!"a.



RB_j mam 7

Per3ia,a! Per3e-&/&a! d" ,e!deri-a>kel&ar"a Pemerik3aa! 0i3ik dia"!$3-ik Pemerik3aa! darah>&ri! r&-i! P&a3a +? /am 3eel&m!a Tdk me!""&!aka! $a-: a!-i k$!5&l3a!4 hi,!$-ik

3eda-i04 li-hi&m da! re3er,i!4 1l$3aril Rek-&m4 5e3ika &ri!aria dik$3$!"ka! ;a/& dil$!""arka!4 "i"i ,al3& dile,a3



RB_j mam 8

@a3e+0a3e ECT @a3e la-e! +6 de-ik4 -rem$r 1e,a- @a3e ke/a!" -$!ik '7 de-ik4 d" a&ra @a3e ke/a!" kl$!ik 7 de-ik @a3e ,e!&r&!a! ke/a!"4 el&m 3adar el&m

er!a,a3

@a3e !a,a3 3,$!-a!4 irama !a,a3 el&m !$rmal @a3e 3adar da! di3$rie!-a3i 6 me!i- @a3e -id&r 7 ?7 me!ir



RB_j mam 9

E0ek 3am,i!" Selal& -er/adi:

,e!daraha! lem&- di$-ak4 am!e3ia4 3ia!$3i34

a,!&e4 3i!k$,e Tdk 3elal&:

iir>lidah -er"i"i-4 "i"i "$a!"4 l&k3a3i

ma!di&la4 di3l$ka3i ka,&- h&meri4 0rak-&r5er-era + le!"a! + -&!"kai4 ,e!eara!rada!"4 ,!e&m$!ia kr! a3,ira3i4 a,!&emema!/a!" da! am!e3ia lama



RB_j mam 10

@rek&e!3i da! keerha3ila! @rek&e!3i:

dierika! 6 '7 kali4 i3a di&la!" kali Keerha3ila!: + -er/adi ke/a!" -$!ik kl$!ik ("ra!d mall)

+ diik&i-i !a,a3 3,$!-a!4 3adar4 -dk a,!&e+

3ia!$3i34 am!e3ia -dk lama + e0ek mer&"ika! -dk ada>mi!imal.

+ ,eraika! 3im-$m !a-a.



RB_j mam 11

ECT %$!i-$r> Premedika3i =ile!"ka,i ala- m$!i-$r da! me!""&!aka! $a- ,remedika3i Ala- da! $a- ,remedika3i: + m$!i-$ri!" elek-r$ 1$!5&l3i5e -hera,i dile!"ka,i d" ala-

m$!i-$r EEG4 EKG4 5i-al 3i"! da! 3a-&ra3i $k3i"e! + 5e!-ila-$r AR@ 77 II ACO%A a-a& Re3,ira-$r @O 7 S

ACO%A dile!"ka,i d" m$&-h "a" ( ,e!""a!/al "i"i )4

lari!"$31$,e4 e!d$-ra1heal -&e da! -a&!" 7k3i"e! B 7 + !am,a! ( -ra ) &-k -em,a-: a. di3,$3ile 3&l0a3 a-r$,i! ( SA ) 746 746 m" I%>IV>SC . di3,$3ile Na-ri&m ,e!-h$-al (-hi$,e!-al) '7 11>77 m"

(+* m">k" ;;) IV > me-h$hek3i-al (re5i-al) ?7 m" ('m" >k" ;;) > meda#$lam (d$rmik1&m) '6 m" (74 m">k" ;;) 1. di3,$3ile 3&11i!l 1h$li!e 6 11> ?7 m" IV



RB_j mam 12

Pema3a!"a! Elek-r$de ;ila-eral da! &!ila-eral ;ila-eral: elek-r$de ,d ma3i!"+ma3i!"

hemi30er. U!ila-eral: hemi30er !$!d$mi!a! (hemi30er ka!a!)

U!ila-eral: e0ek 3am,i!" D ri!"a!4re3,$! -era,i k&ra!"

;ila-eral: re3,$! -era,i D 1e,a-



RB_j mam 13

%edika3i er3ama ECT

A!-i ,3ik$-ik (B)4 he-er$3iklik (B)4 %AOI (B) ;e!#$dia#e,i! (+) 3ea: a!-ik$!5&l3i Li-hi&m Ca (+): deliri&m4 ak-i5i-a3 ke/a!" lama Cl$#a,i!e (+): ,erkema!"a! ke/a!" lama- Re3er,i!e (+): ""! ,er!a,a3a! B kardi$5a3k&ler Lid$1ai! (l$1ai!)(+): ama!"ke/a!" me!i!"ka- The$,hlli!e (+): lama ke/a!" me!i!"ka-



RB_j mam 14

E0ek 3am,i!" E0ek 1ereral am!e3ia4 a,!&e4

deleri&m da! k$!0&3i$! Aler"i da! Ari-mia /a!-&!" Kema-ia! kr! a!e3-e3i &m&m da!

k$m,lika3i kardi$ 5a3k&ler



RB_j mam 15

Peredaa! a!-ara

ECT%$!i-$r d" ECT K$!5e!3i$!al Ala-: %ECTA (m$!i-$r

Ele1-r$ C$! 5&l3a-$rThera,i A,ara-&3) era-4

m&-akhir d" m$!i-$r O,era-$r $ra!" Oa- ,remedika3i E0ek 3am,i!" D era-

da! D 3ediki- KI D 3ediki- Ke/a!" ri!"a!

mahal

Ala-: K$!5&l3a-$r 3ieme!

ri!"a!4 3ederha!a4 -dkme!""&!aka! m$!i-$r

O,era-$r * $ra!" Ta!,a ,remedika3i

E0ek 3am,i!" D ri!"a! da!D a!ak KI D a!ak Ke/a!" era-

m&rah

Elektro Convulsive Therapi Edt ( Ect )

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