THE "ADEQUATE RELAXATION INTERIM" FOLLOWING SUCCINYLCHOLINE ADMINISTRATION IN ELECTROSHOCKTHERAPY
CHARLES BUCKMAN M.D.,
ARTHUR KRELL M.D.,
IRVING PINSLEY M.D.,
ARTHUR S. IMPASTATO M.D., , and
DAVID J. IMPASTATO M.D.1
1 Kings Park State Hospital, N.Y.
The foregoing investigation demonstrates that the SCC injection causes relaxation lasting for a variable time depending upon the EST technic used. With the classic AC treatment the interim begins 20 seconds following the appearance of perioral fasciculations and lasts for 20 seconds. With the PM-GM technic the interim begins in 10 seconds and lasts 70 seconds.
After 40 seconds with the Standard Technic and 70 seconds with the PM-GM Technic, the degree of relaxation lessened and treatments given at this time or later are potentially capable of producing injury. It may therefore be concluded that with the Standard Technic, without using barbiturates and quickly injecting 15 mg. of SCC, one should not wait longer than 40 seconds after the onset of perioral fasciculations. To administer the grand mal with the PM-GM Technic it is apparently [see source pdf figure 2] safe to wait up to 70 seconds. We were surprised to discover that the double petit mal greatly prolonged the "adequate relaxation interim." A possible explanation for this might be that the petit mal application releases acetylcholine which re-enforces and prolongs the action of SCC. Further study to discover the actual reason why the petit mal re-enforces and prolongs the action of SCC, should be undertaken.
