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Electroconvulsive Therapy Anesthesia Practice Patterns: Results of A UK Postal Survey

Bwalya, Godfrey M. BSc, MB, ChB, FRCA*; Srinivasan, Venkatasubramanian MD, MMedSc, FCARCSI*; Wang, Michael BSc, MSc, PhD, CPsychol, FBPsS

doi: 10.1097/YCT.0b013e3181df1d4f
Original Studies

Objective: To review anesthesia practice patterns associated with electroconvulsive therapy (ECT) in the UK.

Methods: A 12-item questionnaire survey on the practice of ECT anesthesia was sent to all units in the UK identified as providing ECT services.

Results: One hundred thirty active ECT units were identified. Sixty-six (51%) responded. Forty-five percent of respondents worked in units located within acute hospital boundaries and 53% outside acute hospital boundaries. Forty-seven percent of respondents were associated with units providing consultant anesthetic cover for 75-100% of ECT sessions. Twenty-seven percent of the units did not use capnography, 17% did not use continuous electrocardiography, and 16% did not use noninvasive blood pressure monitoring.

Limitations: Results were entirely from respondents. No practices were directly observed.

Conclusions: Although there is apparent widespread recognition of ECT Accreditation Service guidelines, compliance with recommended standards is variable. Given the typically high comorbidity of ECT patients, and indications of elevated anesthetic risk from non-UK studies, this has important implications for the safety of ECT anesthesia in the UK.

From the *Division of Anaesthesia and Critical Care, Hull and East Yorkshire NHS Hospitals Trust, Hull; and †Clinical Psychology Unit, University of Leicester, Leicester, UK.

Received for publication November 21, 2009; accepted February 16, 2010.

Reprints: Godfrey M. Bwalya, BSc, MB, ChB, FRCA, Department of Anaesthesia, Hull Royal Infirmary, Anlaby Rd, Hull HU15 1LL, UK (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.