Administration of succinylcholine for electroconvulsive therapy after organophosphate poisoning: a case study.
A 53-year-old man was admitted to the hospital psychiatric unit for evaluation and treatment following a recent suicide attempt, which involved ingestion of an unknown amount of Dursban (DowElanco, Indianapolis, Ind) and a self-inflicted knife wound to the abdomen. Dursban is a commercially prepared organophosphate insecticide in which the active ingredient is chlorpyrifos in a petroleum distillate solvent. The patient received 7 electroconvulsive therapy treatments during a 2-week hospital stay. The anesthetic regimen included methohexital for induction and succinylcholine for neuromuscular relaxation. Cholinesterase levels were low on admission at 5,780 IU (reference range, 11,000-15,000), yet succinylcholine was used successfully at low doses.
Dillard
M
M
Freeman Hospital, Joplin, Mo., USA.
Webb
J
J
D000768:Anesthesia, General / Q000379:methods* / Q000451:nursing; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D004390:Chlorpyrifos / Q000506:poisoning*; D002802:Cholinesterases / Q000097:blood; D004565:Electroconvulsive Therapy / Q000379:methods*; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D008723:Methohexital / Q000627:therapeutic use; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000627:therapeutic use*; D013390:Succinylcholine / Q000627:therapeutic use*; D013406:Suicide, Attempted
D018686:Anesthetics, Intravenous; D007306:Insecticides; D009467:Neuromuscular Depolarizing Agents; D008723:Methohexital; D002802:Cholinesterases; D013390:Succinylcholine; D004390:Chlorpyrifos