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March 6, 1967

Comparison Between Diazepam and Sodium Thiopental During DC Countershock

Author Affiliations

From the Section of Cardio-respiratory Diseases, Division of Medicine, Presbyterian-St. Luke's Hospital, and the Department of Medicine, University of Illinois College of Medicine, Chicago.

JAMA. 1967;199(10):758-760. doi:10.1001/jama.1967.03120100120035

SYNCHRONIZED, external direct-current (DC) countershock has proved to be a valuable tool for the correction of cardiac arrhythmias since its introduction by Lown and his co-workers in 1962.1,2 Sodium thiopental has been used as the anesthetic agent for this procedure in most clinical studies.3-5 Recently, Nutter and Massumi6 reported using diazepam intravenously for the brief period of analgesia-amnesia necessary for DC countershock.

In this laboratory 108 patients have had elective DC countershock, in the period August 1962 to December 1965, under sodium thiopental anesthesia. Analysis of continuous electrocardiograms made before, during, and after the DC countershock disclosed the occurrence of premature ventricular contractions in many patients. In each instance when this additional arrhythmia occurred, it appeared after induction of anesthesia but before the DC countershock was given. The occurrence of this additional arrhythmia was disturbingly frequent. These premature ventricular complexes often persisted for several minutes after the