General anaesthesia for laparoscopic umbilical hernia repair in a patient with pseudocholinesterase deficiency: a case report
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20240385Keywords:
Pseudocholinesterase deficiency, General anaesthesia, Neuromuscular block, Neuromuscular monitoring, Anaesthesia awarenessAbstract
Pseudocholinesterase deficiency is a condition that causes prolonged muscle weakness when succinylcholine or mivacurium is used as a neuromuscular blocking agent. It can be either inherited or acquired. The practice of not using these two muscle relaxant agents may suggest that PED is not a significant problem for general anesthesia. This case report describes the successful discharge of a patient with a preexisting diagnosis of PED who underwent laparoscopic umbilical hernia repair under GA with neuromuscular monitoring without complications.
Metrics
References
Andersson ML, Møller AM, Wildgaard K. Butyrylcholinesterase deficiency and its clinical importance in anesthesia: a systematic review. Anesthesia. 2019;74(4):518-28.
Lockridge O. Review of human butyrylcholinesterase structure, function, genetic variants, history of use in the clinic, and potential therapeutic uses. Pharmacol Ther. 2015;148:34-46.
Cynthia LA, Matthias E. Neuromuscular Blockers and Reversal Drugs. Pharmacol Physiol Anesth. 2019;34: 428-54.
Lang J, Kunsman S, Hartman MT. Acquired pseudocholinesterase deficiency. Curr Anaesth Crit Care. 2010;21(5-6):297-8.
Wichmann S, Færk G, Bundgaard JR. Patients with prolonged effects of succinylcholine or mivacurium had novel mutations in the butyrylcholinesterase gene. Pharmacogenet Genom. 2016;26(7):351-6.
Niazi A, Leonard IE, O'Kelly B. Prolonged neuromuscular blockade as a result of malnutrition-induced pseudocholinesterase deficiency. J Clin Anesth. 2004;16(1):40-2.
Zhang C, Cao H, Wan ZG, Wang J. Prolonged neuromuscular block associated with cholinesterase deficiency. Medicine. 2018;97(52):e13714.
Thomsen JL, Nielsen CV, Palmqvist DF, Gätke MR. Premature awakening and underuse of neuromuscular monitoring in a registry of patients with butyrylcholinesterase deficiency. Br J Anaesth. 2015; 115(1):89-94.
Robles A, Michael M, McCallum R. Pseudocholinesterase Deficiency: What the Proceduralist Needs to Know. Am J Med Sci. 2019; 357(3):263-7.
Zhou W, Lv S. Delayed recovery from paralysis associated with plasma cholinesterase deficiency. Springerplus. 2016;5(1):1887.
Wecksell M, Koutsospyros D. Pseudocholınesterase defıcıency in a octogenarıan Undergoıng Total intravenous anesthesıa; Implications For Neuromonitoring. Middle East J Anaesthesiol. 2015; 23(2):157-62.
