title: Canadian survey of perianesthetic care for patients receiving electroconvulsive therapy.
abstract: OBJECTIVE
  We report on the anesthesia subsection of a comprehensive nationwide survey (Canadian Electroconvulsive Therapy Survey/Enquête canadienne sur les electrochocs) on the practice of electroconvulsive therapy (ECT) in Canada.
  
  
  METHODS
  This comprehensive survey was sent to the 175 Canadian institutions identified as providers of ECT in 2007. Among other topics, 9 anesthesia-related questions were administered regarding anesthesiology consultation; high-risk patients; credentials of the anesthesia provider; monitoring, airway, and resuscitation equipment; anesthetic induction, muscle relaxant, vasoactive, and other perianesthetic drugs and practices; and postanesthetic discharge.
  
  
  RESULTS
  Sixty-one percent (107/175) of the institutions returned completed survey questionnaires. More than 70% of the sites reported pre-ECT anesthesiology consultation for all (61%) or most (11%) patients. In more than 90%, a Canadian Royal College-certified anesthesiologist, or equivalent, provided anesthetic care. Routine use of oximetry, electrocardiography, and blood pressure monitoring were reported by all but 2 sites; use of bite block was reported by all but 4 sites; and preoxygenation was reported by all but 7 sites. Dantrolene and capnography were not reported as readily available by 35% and 40%, respectively, with comparatively less frequent availability at non-operating room and lower-volume sites.
  
  
  CONCLUSIONS
  These results suggest safe practices of anesthesia for ECT in Canada. Further attention needs to be paid to ready availability of dantrolene and capnography, particularly at non-operating room ECT sites. Improvements in anesthetic care of patients undergoing ECT may be realized through continued knowledge translation efforts and by expanding access to currently unavailable anesthetic induction agents and, in some settings, limited clinical anesthesiology resources.
authors.affiliation: Department of Anesthesiology, Queen's University, Kingston, Ontario, Canada. gilroni@queensu.ca
authors.forename: Ian
authors.initials: I
authors.lastname: Gilron
authors.forename: Nicholas
authors.initials: N
authors.lastname: Delva
authors.forename: Peter
authors.initials: P
authors.lastname: Graf
authors.forename: Peter
authors.initials: P
authors.lastname: Chan
authors.forename: Murray
authors.initials: M
authors.lastname: Enns
authors.forename: Caroline
authors.initials: C
authors.lastname: Gosselin
authors.forename: Mark
authors.initials: M
authors.lastname: Jewell
authors.forename: James Stuart
authors.initials: JS
authors.lastname: Lawson
authors.forename: Barry
authors.initials: B
authors.lastname: Martin
authors.forename: Roumen
authors.initials: R
authors.lastname: Milev
authors.forename: Simon
authors.initials: S
authors.lastname: Patry
mesh_terms: D058109:Airway Management; D000758:Anesthesia; D000777:Anesthetics; D002170:Canada / Q000453:epidemiology; D003406:Credentialing; D004565:Electroconvulsive Therapy / Q000379:methods*; D019538:Health Care Surveys; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D009125:Muscle Relaxants, Central; D005791:Patient Care / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000592:standards; D012017:Referral and Consultation; D012151:Resuscitation / Q000295:instrumentation; D012308:Risk Management; D011795:Surveys and Questionnaires
chemical_list: D000777:Anesthetics; D009125:Muscle Relaxants, Central