L’Électroconvulsivothérapie (ECT) aujourd’hui

[Survey on anaesthetic practices for electroconvulsivotherapy in French university hospitals]

OBJECTIVES

To evaluate the anaesthetic management of electroconvulsive therapy (ECT) in French university hospitals.

STUDY DESIGN

National survey in university hospitals by mail.

MATERIALS AND METHODS

An email was sent to heads of department of anaesthesiology in French university hospitals to identify a referent practitioner, which we then sent a computerized quiz. The questions were about the volume and organization of the activity, pre-, per- and post-anaesthetic management of patients undergoing ECT.

RESULTS

Of the 33 sites performing ECT, 28 (85%) responded. The anaesthesia consultation was systematic at least 48 hours before the start of treatment but the preanaesthetic visit was performed in 32% of the centers. A routine electrocardiogram was performed in 89% of patients. In four centers (25%), neuromuscular blockade was not systematic. Propofol was the agent most widely used (82%) and etomidate and thiopental in 11% and 7% respectively. In two centers, practitioners did not report using oral protection. The psychiatrist was present in 71% of cases. The electroencephalogram was continuously recorded in 45% of the centers.

CONCLUSION

The recommendations remain valid while old and may be updated. They are not always followed by the teams. Continuing medical education should be promoted to a better understanding of the factors interfering between anesthesia and ECT.