Clinical Case Database / Category: Patient Management
Suxamethonium apnoea during electroconvulsive therapy
Dr James Hillier MA, MBBS, FRCA, FFICM, Dr Pamela Tizzoni MBChB
Foundation Years Journal, volume 9, issue 8, p.11 (123Doc Education, London, September 2015)
This article describes a case of suxamethonium apnoea during ECT, highlighting this rare, but important adverse effect. It discusses how it is recognised, the immediate management and subsequent investigations, as well as discussing the risks of anaesthesia in remote areas.
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Dr James Hillier MA, MBBS, FRCA, FFICM (Corresponding author)
University Hospitals Bristol NHS Foundation Trust, BS2 8HW
Dr Pamela Tizzoni MBChB
North Bristol NHS Trust, BS10 5NB
1. World federation of societies of anaesthesiologists. Anaesthesia Tutorial of the week 306. Anaesthesia for electro-convulsive therapy. 2014. http://www.wfsahq.org/documents/306 Anaesthesia for Electro-convulsive Therapy ECT.pdf
2. Uppal V, Dourish J, Macfarlane A. Anaesthesia for electroconvulsive therapy. British Journal of Anaesthesia. Continuing education in anaesthesia, critical care & pain. 2010, 10(6):192-196.
3. Mirzakhani H, Welch C, Eikermann M, Nozari A. Neuromuscular blocking agents for electroconvulsive therapy: a systematic review. Acta Anaesthesiologica Scandinavica. 2011;56(1):3-16.
4. Update in Anaesthesia. Suxamethonium Apnoea. http://e-safe anaesthesia.org/e_library/13/Suxamethonium_apnoea_Update_2003.pdf
5. AnaesthesiaUK. Suxamethonium. http://www.frca.co.uk/article.aspx?articleid=229
6. The Royal College of Anaesthetists. Anaesthetic services in remote sites. 2014. http://www.rcoa.ac.uk/system/files/REMOTE-SITES-2014_3.pdf
7. Guidelines for the provision of anaesthetic services. Chapter 7. Anaesthesia services for care in the non-theatre environment 2015. http://www.rcoa.ac.uk/system/files/GPAS-2015-07-ANTE.pdf
8. Hooten W, Rasmussen K. Effects of General Anesthetic Agents in Adults Receiving Electroconvulsive Therapy. The Journal of ECT. 2008, 24(3):208-223.
9. Lab Tests Online UK. Suxamethonium apnoea. http://labtestsonline.org.uk/understanding/conditions/suxamethonium-apnoea/?show_all=1&printpreview=1
10. Lab Tests Online UK. Cholinesterase Test. http://labtestsonline.org.uk/understanding/analytes/cholinesterase/tab/sample
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All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.
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When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.
About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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