The Use of Ports for Intravenous Access in Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a procedure to treat complex psychiatric conditions and requires serial treatments. Patients may undergo twelve or more treatments acutely and many continue maintenance ECT for longer-term management. Intravenous (IV) access is necessary to administer medications during ECT, including those for anesthesia, muscle relaxation, and blood pressure management. Peripheral IV access can become challenging over time due to repeated IV insertions and/or poor venous access. Many patients in our ECT cohort are recommended to have a port, a totally implantable venous-access device, placed to facilitate IV access during their treatment course. We conducted a 5-year chart review to evaluate the demographics of patients who received a port in our ECT cohort and to better understand the possible complications of port placement. Thirty-nine ECT patients were identified as having IV port placement during the 5-year study period. Port placement was more common in females, younger patients, those with catatonia, and patients receiving longer-term or maintenance ECT. There was a low rate of serious complications, and no fatalities were associated with having a port. We conclude that the use of ports is a safe and important option for IV access, especially in patients receiving maintenance ECT.