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SUCCINYLCHOLINE CHLORIDE IN ELECTROSHOCK THERAPY: II. Cardiovascular Reactions

SUCCINYLCHOLINE CHLORIDE IN ELECTROSHOCK THERAPY: II. Cardiovascular Reactions Abstract IN THE preceding paper, clinical data were presented concerning electroshock therapy in conjunction with administration of the muscle-relaxant drug succinylcholine chloride. Some of the other muscle-relaxant drugs have a definite effect directly on the autonomic system and thus indirectly on the circulation. Tubocurarine (d-tubocurarine) chloride is said to produce partial blockade of the autonomic system,1 while gallamine (Flaxedil) initiates a tachycardia through its inhibiting effect on the cardiac vagal fibers.2 Tubocurarine chloride also produces a decrease in systemic blood pressure which is not prevented by atropine. This effect is thought to be partially related to its autonomic ganglion-blocking properties and partially to a histamine liberation.3 The latter property is responsible for the bronchospasm which is occasionally seen in clinical anesthesia. Although succinylcholine is closely related chemically to the ganglion-blocking (hypotensive) methonium drugs and to acetylcholine, previous workers4 have been unable to show any adverse effect on References 1. References 7, 8, 9, 10, and 11. 2. Burstein, C. L.; Jackson, A.; Bishop, H. F., and Rovenstine, E. A.: Curare in the Management of Autonomic Reflexes , Anesthesiology 11:409-421 ( (July) ) 1950.Crossref 3. Riker, W. F., Jr., and Wescoe, W. C.: The Pharmacology of Flaxedil, with Observation of Certain Analogs , Ann. New York Acad. Sc. 54:373-394 ( (Oct.) ) 1951.Crossref 4. Landmesser, C. M.: A Study of Bronchoconstrictor and Hypotensive Actions of Curarizing Drugs , Anesthesiology 8:506-523 ( (Sept.) ) 1947.Crossref 5. Bourne, J. G.; Collier, H. O. J., and Somers, G. F.: Succinylcholine (Succinoylcholine): Muscle-Relaxant of Short Duration , Lancet 1:1225-1229 ( (June 21) ) 1952.Crossref 6. Adderley, D. J., and Hamilton, M.: Use of Succinylcholine in E. C. T.: With Particular Reference to Its Effect on Blood Pressure , British M. J. 1:195-197 ( (Jan. 24) ) 1953.Crossref 7. Bankhead, A. J.; Torrens, J. K., and Harris, T. H.: The Anticipation and Prevention of Cardiac Complications in Electroconvulsive Therapy , Am. J. Psychiat. 106:911-917 ( (June) ) 1950. 8. Beard, B. H., and Harris, T. H.: A Near Fatality from Curare Preceding Electro-Shock Therapy , Dis. Nerv. System 7:276-277 ( (Sept.) ) 1946. 9. Bennett, H. E.: Misconceptions Concerning Hazards of Curarization with Electroshock , Dis. Nerv. System 9:219-221 ( (July) ) 1948. 10. Foregger, R.: Fatalities Following Curare , J. A. M. A. 142:1344-1348 ( (April 29) ) 1950.Crossref 11. Foregger, R.; Rettig, H., and Conroy, C.: Massive Pulmonary Collapse Following Anesthesia with Curare , Wisconsin M. J. 48:1004-1006 ( (Nov.) ) 1949. 12. Elaugh, F. G.; Barnacle, C. H., and Neubuerger, K. T.: Fatalities Following Electric Convulsive Therapy , Arch. Neurol. & Psychiat. 49:107-117 ( (Jan.) ) 1943. 13. Will, O. A., Jr.; Rehfeldt, F. C., and Neumann, M. A.: A Fatality in Electroshock Therapy: Report of a Case and Review of Certain Previously Described Cases , J. Nerv. & Ment. Dis. 107:105-126 ( (Feb.) ) 1948. 14. Stephen, C. R.; Martin, R., and Nowill, W. K., to be published. 15. Wilkinson, W. E.: Observations Pertaining to Electric Shock Therapy , Dis. Nerv. System 13:355-359 ( (Dec.) ) 1952. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

SUCCINYLCHOLINE CHLORIDE IN ELECTROSHOCK THERAPY: II. Cardiovascular Reactions

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Publisher
American Medical Association
Copyright
Copyright © 1954 American Medical Association. All Rights Reserved.
ISSN
0096-6886
DOI
10.1001/archneurpsyc.1954.02320380055007
Publisher site
See Article on Publisher Site

Abstract

Abstract IN THE preceding paper, clinical data were presented concerning electroshock therapy in conjunction with administration of the muscle-relaxant drug succinylcholine chloride. Some of the other muscle-relaxant drugs have a definite effect directly on the autonomic system and thus indirectly on the circulation. Tubocurarine (d-tubocurarine) chloride is said to produce partial blockade of the autonomic system,1 while gallamine (Flaxedil) initiates a tachycardia through its inhibiting effect on the cardiac vagal fibers.2 Tubocurarine chloride also produces a decrease in systemic blood pressure which is not prevented by atropine. This effect is thought to be partially related to its autonomic ganglion-blocking properties and partially to a histamine liberation.3 The latter property is responsible for the bronchospasm which is occasionally seen in clinical anesthesia. Although succinylcholine is closely related chemically to the ganglion-blocking (hypotensive) methonium drugs and to acetylcholine, previous workers4 have been unable to show any adverse effect on References 1. References 7, 8, 9, 10, and 11. 2. Burstein, C. L.; Jackson, A.; Bishop, H. F., and Rovenstine, E. A.: Curare in the Management of Autonomic Reflexes , Anesthesiology 11:409-421 ( (July) ) 1950.Crossref 3. Riker, W. F., Jr., and Wescoe, W. C.: The Pharmacology of Flaxedil, with Observation of Certain Analogs , Ann. New York Acad. Sc. 54:373-394 ( (Oct.) ) 1951.Crossref 4. Landmesser, C. M.: A Study of Bronchoconstrictor and Hypotensive Actions of Curarizing Drugs , Anesthesiology 8:506-523 ( (Sept.) ) 1947.Crossref 5. Bourne, J. G.; Collier, H. O. J., and Somers, G. F.: Succinylcholine (Succinoylcholine): Muscle-Relaxant of Short Duration , Lancet 1:1225-1229 ( (June 21) ) 1952.Crossref 6. Adderley, D. J., and Hamilton, M.: Use of Succinylcholine in E. C. T.: With Particular Reference to Its Effect on Blood Pressure , British M. J. 1:195-197 ( (Jan. 24) ) 1953.Crossref 7. Bankhead, A. J.; Torrens, J. K., and Harris, T. H.: The Anticipation and Prevention of Cardiac Complications in Electroconvulsive Therapy , Am. J. Psychiat. 106:911-917 ( (June) ) 1950. 8. Beard, B. H., and Harris, T. H.: A Near Fatality from Curare Preceding Electro-Shock Therapy , Dis. Nerv. System 7:276-277 ( (Sept.) ) 1946. 9. Bennett, H. E.: Misconceptions Concerning Hazards of Curarization with Electroshock , Dis. Nerv. System 9:219-221 ( (July) ) 1948. 10. Foregger, R.: Fatalities Following Curare , J. A. M. A. 142:1344-1348 ( (April 29) ) 1950.Crossref 11. Foregger, R.; Rettig, H., and Conroy, C.: Massive Pulmonary Collapse Following Anesthesia with Curare , Wisconsin M. J. 48:1004-1006 ( (Nov.) ) 1949. 12. Elaugh, F. G.; Barnacle, C. H., and Neubuerger, K. T.: Fatalities Following Electric Convulsive Therapy , Arch. Neurol. & Psychiat. 49:107-117 ( (Jan.) ) 1943. 13. Will, O. A., Jr.; Rehfeldt, F. C., and Neumann, M. A.: A Fatality in Electroshock Therapy: Report of a Case and Review of Certain Previously Described Cases , J. Nerv. & Ment. Dis. 107:105-126 ( (Feb.) ) 1948. 14. Stephen, C. R.; Martin, R., and Nowill, W. K., to be published. 15. Wilkinson, W. E.: Observations Pertaining to Electric Shock Therapy , Dis. Nerv. System 13:355-359 ( (Dec.) ) 1952.

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: Feb 1, 1954

References