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

Anesth Analg. 2017 Jun;124(6):1943-1956. doi: 10.1213/ANE.0000000000001873.


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.

Publication types

  • Review

MeSH terms

  • Anesthesia / adverse effects
  • Anesthesia / methods*
  • Anesthesia / standards
  • Central Nervous System Agents / adverse effects
  • Clinical Decision-Making
  • Comorbidity
  • Electroconvulsive Therapy* / adverse effects
  • Electroconvulsive Therapy* / standards
  • Health Status
  • Humans
  • Neuromuscular Blocking Agents / therapeutic use
  • Patient Care Team
  • Patient Safety
  • Patient Selection
  • Practice Guidelines as Topic
  • Respiration, Artificial
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome


  • Central Nervous System Agents
  • Neuromuscular Blocking Agents