Strategies from A Multi-National Sample of Electroconvulsive Therapy (ECT) Services: Managing Anesthesia for ECT during the COVID-19 Pandemic
, Grace Branjerdporn 1,2, Laura McCosker 1,3, Sean Kenworthy 1,2, Leanne Ryan 1, Vanessa Dong 4,5, Donel Martin 4,5, Halia O’Shea 1 and Colleen Loo 4,5Round 1
Reviewer 1 Report
This manuscript focused on 41 quantitative questions about the impact of the COVID-19 pandemic on ECT procedures and anesthesia. Results on the other questions are reported in other publications. The questions included were as follows:
If the service changed its anaesthetic technique
1- Shortage in drugs or anaesthetics
2- If the shortage of anaesthetic staff affected the practice of ECT
The topic is of great relevance to psychiatry, anesthesia, the COVID-19 pandemic and possible future pandemics
The mixed-methods approach allows a wide range of responses due to quantitative and qualitative inputs
# Perhaps the 41 quantitative questions (multiple choice and Likert scale) can be placed in a separate topic in the supplemental material section.
# Line 106: please check the calculation. Should it be 85+26 = 111?
# Etomidate was not included/used? Why?
I understand the limitations of collecting data during the pandemic. But perhaps more services/doctors should have been included.
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
77% of responses were provided by clinical directors and only 23% by anaesthesiologists. The aim of the study was the influence of COVID on ECT anesthesia. What does the director know about this?
The main strategies for anesthesia management (induction, ventilation, etc.) are specified, but the manuscript could not provide information on what were the changes in anesthetic techniques.
Quoting selected responses from the survey does not allow any conclusions to be drawn. Moreover, they are provided by the principals and not by the anaesthesiologists who are directly involved in the procedure.
What is the information contained in table 3 for? What conclusions can be drawn from this data for anesthesiologists and psychiatrists?
The charts repeat data from the table (either tables or charts).
In Discussion, the authors discuss specific aspects of anesthesia in ECT modified by COVID. It resembles a review paper rather than a discussion of your own results.
In Limitation, the authors themselves explain why the manuscript should not be published.
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Reviewer 3 Report
The fact that this is the first study of its kind has been mentioned repetitively. Please edit. The last couple of statements for the conclusion seem vague. 'It is important in supporting services to prepare 417 for the next pandemic.'. What is important?
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
the manuscript has been
sufficiently improved
