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Updated: Jun 8, 2026
Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Mask ventilation, hypocapnia, and seizure duration in electroconvulsive therapy
Christopher G Choukalas1, James Walter, David Glick
1Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA 94143, USA. cchoukal@gmail.com
Study Objective:
To compare the Mapleson D circuit and the bag-valve-mask device for mask ventilation of patients undergoing electroconvulsive therapy (ECT).
Design:
Cross-over study.
Setting:
Single-center academic medical center.
Patients:
18 patients undergoing ECT for major depressive disorder.
Interventions:
Patients were randomized to undergo mask ventilation by the Mapleson D circuit or the bag-valve-mask device.
Measurements:
End-tidal CO(2), seizure duration, and airway pressure values were recorded.
Main Results:
End-tidal CO(2) was significantly lower with the bag-valve-mask device. When compared with the bag-valve-mask device, ventilation with the Mapleson circuit resulted in rebreathing of CO(2) in nearly all patients, shorter expiratory time, and lower pressure ramp slope.
Conclusions:
Hypocapnia was not associated with longer seizures, and the user-device interaction might affect device performance.
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