A 48-year-old woman requires electroconvulsive therapy (ECT) for treatment-resistant depression. The purpose of using succinylcholine during ECT is:

• A To prolong seizure duration and improve therapeutic efficacy
• B To deepen the level of anaesthesia and prevent awareness during the electrical stimulus
• C To prevent bradycardia from the vagal response to the electrical stimulus
• D To attenuate the peripheral motor manifestations of the generalised seizure and prevent musculoskeletal injury ✓

Explanation

Succinylcholine (1–1.5 mg/kg IV) is given in ECT to produce complete motor paralysis, thereby converting a generalised tonic-clonic convulsion into only a brief EEG seizure, which prevents the musculoskeletal complications of unmodified ECT: vertebral compression fractures, joint dislocations, and soft tissue injury. The drug does not influence seizure duration or therapeutic efficacy (EEG seizure quality, duration, and hemisphere spread are unchanged). Glycopyrrolate or atropine, not succinylcholine, is used to prevent the vagal bradycardia.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.