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Anesth Analg 2004;98:1676-1679
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000112313.67414.53

ANESTHETIC PHARMACOLOGY

Muscular Injury After Succinylcholine and Electroconvulsive Therapy

Thewarug Werawatganon, MD, Oranuch Kyokong, MD, MSc, Somrat Charuluxananan, MD, MSc, and Sahadol Punyatavorn, MD

From the Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Address correspondence and reprint requests to Thewarug Werawatganon, Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 10330. Address email to thewarug{at}hotmail.com

Both succinylcholine and seizures cause muscular injury during electroconvulsive therapy. We compared the muscular damage in two groups of patients. The psychiatric patient group received succinylcholine for electroconvulsive therapy. The surgical patient group received succinylcholine for endotracheal intubation. Serum myoglobin was measured as a marker for muscular injury and myalgic symptoms were also recorded. Serum myoglobin increased from baseline in both groups at 5 and 20 min. The surgical patients, however, had a higher myoglobin level than the psychiatric patients at 5 and 20 min after the administration of succinylcholine (P < 0.001). The median (range) of myoglobin concentration at 20 min in psychiatric patients was 32.6 (23.1–60.1) ng/mL, compared with 61.2 (31.6–1687.0) ng/mL in surgical patients. The incidence of myalgia was not different between the two groups. In conclusion, we unexpectedly conclude that the psychiatric patients who received electroconvulsive therapy had less effect of muscular damage associated with succinylcholine than the surgical patients did.

IMPLICATIONS: Both succinylcholine and electroconvulsive therapy cause muscular injury. However, we unexpectedly found that psychiatric patients who received succinylcholine and electroconvulsive therapy had less muscular damage than surgical patients who received succinylcholine for intubation. Therefore, appropriate use of succinylcholine can attenuate the muscular damaging effect from the therapy.




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Anesth. Analg., June 1, 2004; 98(6): 1674 - 1675.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.