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Updated: Apr 11, 2026

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
A naturalistic study on anaesthesia awareness during electroconvulsive therapy
Camille Rouvière1, Romain Dumont2, Samuel Bulteau3
1Nantes Université, CHU de Nantes, 44000 Nantes, France.
Electroconvulsive therapy (ECT) has a low rate of anesthesia awareness with recall (AAWR), with only 1.2‰ events observed. This study proposes an algorithm for managing AAWR during ECT to ensure patient safety.
Area of Science:
- Anesthesiology
- Psychiatry
Background:
- Electroconvulsive therapy (ECT) is a vital non-pharmacological treatment for severe psychiatric disorders.
- General anesthesia safety is paramount, with anesthesia awareness with recall (AAWR) being a significant concern.
- Limited data exists on AAWR incidence during ECT procedures.
Purpose of the Study:
- To determine the incidence of anesthesia awareness with recall (AAWR) during electroconvulsive therapy (ECT).
Main Methods:
- A retrospective observational study analyzed medical records of patients undergoing ECT.
- Data was collected from Nantes University Hospital Centre between 2020 and 2024.
Main Results:
- Six AAWR events (1.2‰) were identified across 4994 ECT sessions.
- Four patients experienced paralysis sensations during consolidation; two patients discontinued ECT due to AAWR.
- An algorithm for AAWR detection and management during ECT was developed.
Conclusions:
- ECT does not appear to carry an elevated risk of AAWR.
- Systematic AAWR monitoring and reporting in medical records are crucial.
- Effective psychological trauma therapies should be provided to affected patients.
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