Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Pharmacology
Medium
What is the purpose of using succinylcholine during the Electroconvulsive therapy?
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- Succinylcholine is a fast-acting, depolarizing neuromuscular blocking agent used universally in ECT.
- Its primary function is to induce profound muscle relaxation, bordering on temporary paralysis.
- This action is critical to prevent the powerful motor activity of an electrically induced seizure from causing physical harm, such as bone fractures, dislocations, or severe muscle strains.
- By modifying the motor component of the seizure, succinylcholine makes the procedure significantly safer for the patient.
Why Other Options Were Wrong
- Option A: The reduction of oral and respiratory secretions is the primary role of anticholinergic medications (e.g., atropine, glycopyrrolate), which are given as part of the premedication for ECT.
- Option C: While succinylcholine does cause initial, transient muscle contractions (fasciculations) due to its depolarizing mechanism, this is a side effect, not the therapeutic goal. The goal is the subsequent paralysis.
- Option D: This option is incorrect because the therapeutic purpose is solely muscle relaxation. The initial muscle contraction (fasciculation) is an expected part of the drug's action but not a desired therapeutic outcome in this setting.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pharmacological management during Electroconvulsive Therapy (ECT) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- The nurse's role during ECT is critical for patient safety. This includes preparing and administering medications as prescribed, monitoring vital signs continuously (heart rate, blood pressure, oxygen saturation), and managing the airway until spontaneous respiration returns.
- Nurses must be vigilant in observing for the initial muscle fasciculations after succinylcholine administration, followed by relaxation, as this confirms the drug is working. They also monitor the duration of the motor seizure, often by observing an isolated limb (cuff technique).
- Post-procedure, the nurse provides supportive care, monitoring for confusion (postictal delirium), headache, nausea, and muscle soreness, and reorienting the patient as they recover from anesthesia.
How to Approach the Question
- First, identify the key components of the question: the drug (succinylcholine) and the clinical context (Electroconvulsive Therapy - ECT).
- Recall the drug class of succinylcholine. It is a neuromuscular blocking agent.
- Think about the nature of ECT. It involves inducing a generalized seizure. Unmodified seizures involve violent muscle contractions that can cause injury.
- Connect the drug's action to the procedure's risk. A neuromuscular blocker (muscle relaxant) would be necessary to prevent injury from the seizure's motor component.
- Evaluate the options based on this logic. 'Muscle relaxant' directly addresses the need to prevent injury during the seizure. 'Reduction in oral secretions' points to a different drug class (anticholinergics). 'Muscle contraction' is the opposite of the intended therapeutic effect.
Concept Tested & Keywords
- Concept Tested: Pharmacological management during Electroconvulsive Therapy (ECT)
- Stem keywords: succinylcholine, Electroconvulsive therapy, ECT, purpose
- Lead-in keywords: What is
- Negative lead-in flag: false
Question ID
q7jVBeQE6pWPvUFiTogUe
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 2304-2306, 2303-2305
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 11193-11195
Practise the full Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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