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Individualized Anesthetic Management for Patients Undergoing Electroconvulsive Therapy: A Review of Current Practice

Bryson, Ethan O. MD*†; Aloysi, Amy S. MD, MPH; Farber, Kate G. BA; Kellner, Charles H. MD

doi: 10.1213/ANE.0000000000001873
Neuroscience and Neuroanesthesiology: Narrative Review Article
Continuing Medical Education

Electroconvulsive therapy (ECT) remains an indispensable treatment for severe psychiatric illness. It is practiced extensively in the United States and around the world, yet there is little guidance for anesthesiologists involved with this common practice. Communication between the anesthesiologist and the proceduralist is particularly important for ECT, because the choice of anesthetic and management of physiologic sequelae of the therapeutic seizure can directly impact both the efficacy and safety of the treatment. In this review, we examine the literature on anesthetic management for ECT. A casual or “one-size–fits-all” approach may lead to less-than-optimal outcomes; customizing the anesthetic management for each patient is essential and can significantly increase treatment success rate and patient satisfaction.

Published ahead of print March 8, 2017.

From the Departments of *Anesthesiology and Psychiatry, The Icahn School of Medicine at Mount Sinai, New York, New York.

Published ahead of print March 8, 2017.

Accepted for publication December 6, 2016.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Reprints will not be available from the authors.

Address correspondence to Ethan O. Bryson, MD, Department of Anesthesiology, One Gustave L. Levy Place, Box 1010, New York, NY 10029. Address e-mail to

© 2017 International Anesthesia Research Society
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