Muscle Relaxation With Succinylcholine in Electroconvulsive Therapy

Li, Erin H.; Bryson, Ethan O.; Kellner, Charles H.

doi:10.1213/ane.0000000000001475

Cited by 5 publications

(1 citation statement)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Attributed to its rapid onset (30 ~ 60 seconds) and brief duration of action (~ 10 minutes) 1, Sch has been used as the “gold standard” for rapid sequence induction (RSI) in emergency situations 2 and the management of laryngospasm 3. Sch is also used to ensure patients' comfort and safety in electroconvulsive therapy 4, 5. As a depolarizing NMBA, Sch is more resistant than acetylcholine (Ach) to degradation by cholinesterase at the neuromuscular junction and other Ach receptors (AchRs) sites, which may continuously depolarize the cells and induce repetitive excitation of the Ach receptors, thereby inducing the efflux of intracellular contents into the blood and causing a variety of side effects.…”

Section: Introductionmentioning

confidence: 99%

Supramolecular therapeutics to treat the side effects induced by a depolarizing neuromuscular blocking agent

Zhang

Qian

et al. 2019

Theranostics

View full text Add to dashboard Cite

Succinylcholine (Sch) is the only depolarizing neuromuscular blocking agent widely used for rapid sequence induction in emergency rooms. Unfortunately, a variety of (sometimes lethal) adverse effects, such as hyperkalemia and cardiac arrest, are associated with its use, and currently there are no specific antidotes to reverse Sch or to treat these side-effects. Methods: The binding behaviors of Sch and several synthetic receptors, including cucurbit[7]uril, sulfo-calix[4]arene and water-soluble carboxylatopillar[6]arene (WP[6]), were first investigated. With a mouse model, a leathal dose of Sch was selected for evaluation of the antidotal effects of these synthetic receptors on Sch induced mortality. The antidotal effects of a selected synthetic receptor, WP[6], on Sch induced cardiac arrhythmias, hyperkalemia, rhabdomyolysis and paralysis were subsequently evaluated with rat and mouse models. The reversal mechanism was also investigated at a cellular level. Results: All of these macrocyclic molecules exhibited relatively high binding affinities with Sch in vitro . In a Sch-overdosed mouse model, immediate injection of these synthetic receptors right after Sch administration increased the overall survival rate, with WP[6] standing out with the most effective antidotal effects. In addition, administration of WP[6] also reversed the paralysis induced by Sch in a mouse model. Moreover, infusion of WP[6] to Sch-overdosed rats reduced the incidence of cardiac arrhythmia, inhibited the otherwise abnormally high serum potassium levels, and relieved the muscular damage. At the cellular level, WP[6] reversed the Sch induced depolarization and reduced the efflux of intracellular potassium. Conclusion: Synthetic receptors, particularly WP[6], exhibited high binding affinities towards Sch, and presented a significant potential as supramolecular therapeutics to treat the various side effects of Sch by specifically sequestering Sch in vivo .

show abstract

Section: Introductionmentioning

confidence: 99%

Supramolecular therapeutics to treat the side effects induced by a depolarizing neuromuscular blocking agent

Zhang

Qian

et al. 2019

Theranostics

View full text Add to dashboard Cite

show abstract

ECT: Patient Selection and Preparation

Kellner¹

2018

Handbook of ECT

View full text Add to dashboard Cite

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange During Electroconvulsive Therapy

Jonker

Rutten

Exel

et al. 2018

J ECT

View full text Add to dashboard Cite

Background In electroconvulsive therapy (ECT), a generalized seizure is provoked under general anesthesia. Standard airway management is done by face mask ventilation, but this is difficult during generalized seizure. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a method to increase apnea tolerance and permit apnea oxygenation. We hypothesize that THRIVE can oxygenate the patient during ECT and that it is comfortable for patients. Methods In this single-center feasibility study, 13 patients with a pharmacotherapy-resistant depressive disorder underwent 20 ECT sessions with the use of THRIVE. They received general anesthesia under standard monitoring and transcutaneous carbon dioxide monitoring. Afterward, they completed a survey comparing their prior experience with face mask oxygenation. Results There were no desaturations during the procedure, and patient comfort showed no difference in comparison to face mask. Compared with data from earlier ECT with face mask ventilation in the same patient, THRIVE did not seem to shorten seizure duration. Conclusions THRIVE is a novel, safe oxygenation method during ECT.

show abstract

Muscle Relaxation With Succinylcholine in Electroconvulsive Therapy

Cited by 5 publications

References 2 publications

Supramolecular therapeutics to treat the side effects induced by a depolarizing neuromuscular blocking agent

Supramolecular therapeutics to treat the side effects induced by a depolarizing neuromuscular blocking agent

ECT: Patient Selection and Preparation

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange During Electroconvulsive Therapy

Contact Info

Product

Resources

About