Atracurium as a Muscle Relaxant for Electroconvulsive Therapy in a Burned Patient.

We present the case of a patient with 80% total body surface area burned who presented for anesthesia and electroconvulsive therapy (ECT) 75 days after the injury. He was presumed to be sensitive to the K(+)-releasing effects of succinylcholine and therefore was given a nondepolarizing neuromuscular blocking agent, atracurium, to which he was shown to be resistant. Anesthesia for ECT on 13 occasions was without incident. Sensitivity and K(+) release secondary to succinylcholine is discussed as well as resistance to non-depolarizing neuromuscular blocking agents.