Development of Prolonged Apnoea in a Suxamethonium-Naïve Patient During Electroconvulsive Therapy: A Case Report

Suxamethonium is commonly used as a muscle relaxant during electroconvulsive therapy (ECT). Prolonged apnoea associated with suxamethonium, mostly caused by pseudocholinesterase deficiency, is rare, but it can sometimes pose a great challenge in managing emergency situations due to patients' inability to breathe; occasionally, it can result in serious complications, including death. We report a case of a young male who had no prior exposure to suxamethonium and developed prolonged apnoea after induction with it. There was no record of any sensitivity or adverse reactions to any drugs for this patient or his family. ECT is a well-known treatment for many psychiatric disorders when other treatments are ineffective. This case emphasizes the need for a comprehensive pre-procedural assessment, careful consideration, and the gathering of crucial information about potential sensitivities and adverse reactions associated with medications commonly used during the ECT procedure, especially when administering these medications for the first time.