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Updated: Aug 23, 2025

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Contemporary Anesthetic Evaluation and Management for Electroconvulsive Therapy
1Swedish Medical Center, Seattle and Issaquah, Washington, USA; Medical Director of Anesthesia Services and Interventional Platform-Swedish Issaquah Hospital, Issaquah, Washington, USA.
Abstract:
Electroconvulsive therapy (ECT) is a medical treatment most often used in patients with severe major depression that has not responded to other treatments. ECT is also indicated for patients with other severe psychiatric conditions, including bipolar disorder, schizophrenia, schizoaffective disorders, catatonia, and neuroleptic malignant syndrome. Contemporary "modified ECT" involves inducing general anesthesia with neuromuscular blockade before inducing the therapeutic seizure. The goal of this review is to combine an evidence-based update with the experience of the author's institution to provide a practical approach to anesthetic care for the patient undergoing ECT.
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