| Electroconvulsive therapy complicated by life-threatening hyperkalemia in a catatonic patient. | |
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MedLine Citation:
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PMID: 16950383 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Electroconvulsive therapy (ECT) requires brief general anesthesia, and succinylcholine is a depolarizing neuromuscular blocking agent that is frequently used for this procedure. Its use leads to intracellular potassium release into the extracellular space, usually increasing the serum potassium level by 0.5-1 mEq/L, with little clinical significance. However, long-term immobilization has been associated with changes at the neuromuscular junction (up-regulation of nicotinic cholinergic receptors) and subsequent serious hyperkalemia following succinylcholine administration. We report the case of a severely obese patient, immobilized due to her catatonic state, who developed life-threatening ventricular tachycardia after succinylcholine administration for ECT. Resumption of normal physical activity reverses these neuromuscular junctional changes, allowing subsequent safe succinylcholine administration. Current drug development may eliminate the need for succinylcholine use during ECT. |
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Authors:
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Jana Hudcova; Roman Schumann |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: General hospital psychiatry Volume: 28 ISSN: 0163-8343 ISO Abbreviation: Gen Hosp Psychiatry Publication Date: 2006 Sep-Oct |
Date Detail:
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Created Date: 2006-09-04 Completed Date: 2007-01-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7905527 Medline TA: Gen Hosp Psychiatry Country: United States |
Other Details:
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Languages: eng Pagination: 440-2 Citation Subset: IM |
Affiliation:
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Department of Anesthesia, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA. jhudcova@tufts-nemc.org <jhudcova@tufts-nemc.org> |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antipsychotic Agents / adverse effects, therapeutic use Bipolar Disorder / blood, drug therapy Catatonia / blood*, therapy* Dose-Response Relationship, Drug Drug Administration Schedule Electroconvulsive Therapy / adverse effects* Female Haloperidol / adverse effects, therapeutic use Humans Hyperkalemia / blood*, chemically induced* Infusions, Intravenous Neuromuscular Depolarizing Agents / administration & dosage, adverse effects* Obesity, Morbid / blood, complications Potassium / blood Risk Factors Schizophrenia / blood, drug therapy Succinylcholine / administration & dosage, adverse effects* Tachycardia, Ventricular / blood, chemically induced |
| Chemical | |
Reg. No./Substance:
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0/Antipsychotic Agents; 0/Neuromuscular Depolarizing Agents; 306-40-1/Succinylcholine; 52-86-8/Haloperidol; 7440-09-7/Potassium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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