AANA Journal course: update for nurse anesthetists--anesthetic management during electroconvulsive therapy: effects on seizure duration and antidepressant efficacy.

Electroconvulsive therapy (ECT) is an effective treatment for some types of depression and psychotic disorders. Although ECT is considered effective and relatively safe, the treatment team must know how to deal with adverse effects. The American Psychiatric Association recognizes no absolute contraindication except brain tumor with increased intracranial pressure. However, patients who have other medical problems are at risk of complications. Optimizing the safety and efficacy of treatment is a goal when providing ECT. Muscle relaxants, barbiturate anesthesia, anticholinergic agents, and oxygenation are used to reduce the risk of complications. The use of ECT requires a knowledge of the effect of anesthetic agents on seizure activity. This article reviews ECT, anesthesia for ECT, and the effect of propofol and methohexital on seizure duration and seizure efficacy.