@article{10.11648/j.ijacm.20231102.13,
  author = {Dongjiao Wu and Xuejie Li},
  title = {A Case of Pseudocholinesterase Deficiency in Patient Underwent General Anesthesia with Flexible Bronchoscopy},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {11},
  number = {2},
  pages = {69-71},
  doi = {10.11648/j.ijacm.20231102.13},
  url = {https://doi.org/10.11648/j.ijacm.20231102.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20231102.13},
  abstract = {Pseudocholinesterase deficiency is a rare clinical condition primarily associated with genetic alterations, but it can also be caused by certain diseases and medication factors. Patients with this condition experience significantly prolonged muscle paralysis when succinylcholine or mivacurium is used during general anesthesia, due to the decreased enzyme levels. The diagnosis of pseudocholinesterase deficiency is typically made after the administration of succinylcholine or mivacurium. Inquiring about the patient's family history is also crucial for proper diagnosis and intervention. Here, we report a case of a rare pseudocholinesterase deficiency patient who experienced delayed recovery following general anesthesia for flexible bronchoscopy. The patient was a healthy 67-year-old male with no history of liver or kidney dysfunction or other diseases. The plan was to perform painless flexible bronchoscopy, and after the procedure, the patient exhibited delayed recovery. Throughout the process, electrocardiographic monitoring showed normal blood pressure, heart rate, and oxygen saturation. After ruling out other factors that could cause delayed emergence, including central nervous system issues and electrolyte imbalances, it was found that succinylcholine, a depolarizing muscle relaxant, had been used. There was a high suspicion of pseudocholinesterase deficiency in the patient. Pseudocholinesterase enzyme activity testing was performed, and the patient was continued on mechanical ventilatory support. After 220 minutes from the completion of the procedure, the patient regained spontaneous breathing and full consciousness, and the endotracheal tube was removed. This article presents a case of delayed recovery in a patient with pseudocholinesterase deficiency following painless flexible bronchoscopy. It also summarizes the causes, clinical manifestations, diagnosis, and treatment of pseudocholinesterase deficiency-related delayed emergence. It is hoped that this article will contribute to timely recognition and management of such cases, thereby preventing any potential adverse outcomes for patients. Furthermore, since pseudocholinesterase deficiency is relatively rare, further research is needed to confirm the effectiveness of the preventive and therapeutic measures mentioned in this article.},
 year = {2023}
}

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TY  - JOUR
T1  - A Case of Pseudocholinesterase Deficiency in Patient Underwent General Anesthesia with Flexible Bronchoscopy
AU  - Dongjiao Wu
AU  - Xuejie Li
Y1  - 2023/07/31
PY  - 2023
N1  - https://doi.org/10.11648/j.ijacm.20231102.13
DO  - 10.11648/j.ijacm.20231102.13
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 69
EP  - 71
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20231102.13
AB  - Pseudocholinesterase deficiency is a rare clinical condition primarily associated with genetic alterations, but it can also be caused by certain diseases and medication factors. Patients with this condition experience significantly prolonged muscle paralysis when succinylcholine or mivacurium is used during general anesthesia, due to the decreased enzyme levels. The diagnosis of pseudocholinesterase deficiency is typically made after the administration of succinylcholine or mivacurium. Inquiring about the patient's family history is also crucial for proper diagnosis and intervention. Here, we report a case of a rare pseudocholinesterase deficiency patient who experienced delayed recovery following general anesthesia for flexible bronchoscopy. The patient was a healthy 67-year-old male with no history of liver or kidney dysfunction or other diseases. The plan was to perform painless flexible bronchoscopy, and after the procedure, the patient exhibited delayed recovery. Throughout the process, electrocardiographic monitoring showed normal blood pressure, heart rate, and oxygen saturation. After ruling out other factors that could cause delayed emergence, including central nervous system issues and electrolyte imbalances, it was found that succinylcholine, a depolarizing muscle relaxant, had been used. There was a high suspicion of pseudocholinesterase deficiency in the patient. Pseudocholinesterase enzyme activity testing was performed, and the patient was continued on mechanical ventilatory support. After 220 minutes from the completion of the procedure, the patient regained spontaneous breathing and full consciousness, and the endotracheal tube was removed. This article presents a case of delayed recovery in a patient with pseudocholinesterase deficiency following painless flexible bronchoscopy. It also summarizes the causes, clinical manifestations, diagnosis, and treatment of pseudocholinesterase deficiency-related delayed emergence. It is hoped that this article will contribute to timely recognition and management of such cases, thereby preventing any potential adverse outcomes for patients. Furthermore, since pseudocholinesterase deficiency is relatively rare, further research is needed to confirm the effectiveness of the preventive and therapeutic measures mentioned in this article.
VL  - 11
IS  - 2
ER  - 

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