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February 1954

SUCCINYLCHOLINE CHLORIDE IN ELECTROSHOCK THERAPY: II. Cardiovascular Reactions

Author Affiliations

DURHAM, N. C.

From the Department of Psychiatry and Division of Anesthesiology, Duke University Hospital and School of Medicine.

AMA Arch NeurPsych. 1954;71(2):189-197. doi:10.1001/archneurpsyc.1954.02320380055007
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

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