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Electroconvulsive Therapy Anesthesia Scale (ECTAS): development and preliminary expert-based evidence of content validity

Year: 2026

Type: article

Abstract: Electroconvulsive Therapy (ECT) is an effective treatment for severe psychiatric conditions, including major depression, schizophrenia, mania, catatonia, and suicidal ideation.1,2 The introduction of general anesthesia has markedly improved the safety and tolerability of the procedure.3 Appropriate anesthetic management should provide adequate hypnosis, neuromuscular blockade, and rapid recovery.4 ECT is commonly performed under general anesthesia induced with an intravenous hypnotic agent followed by succinylcholine because of its rapid onset and short duration of action.5-7 Rocuronium followed by sugammadex represents an effective alternative; however, the additional cost associated with sugammadex may limit its routine use, particularly in resource-constrained settings.8 Neuromuscular monitoring can provide information regarding neuromuscular blockade, 9 whereas assessment of the hypnotic component requires separate consideration.Consequently, bedside assessment remains part of the clinical evaluation performed before electrical stimulus delivery during ECT.

Source: Brazilian Journal of Anesthesiology (English Edition)

DOI: 10.1016/j.bjane.2026.844842