Pseudocholinesterase deficiency, sometimes called butyrylcholinesterase deficiency, is a rare disorder in which the neuromuscular blocking drugs succinylcholine and mivacurium cannot be metabolized properly in the blood plasma. This disorder can either be acquired as a result of certain comorbidities or it can be inherited genetically. Anesthesia providers must understand the pathophysiology of pseudocholinesterase deficiency and be prepared to safely and effectively manage patients who show signs and symptoms consistent with the disorder after the use of the indicated neuromuscular blocking drugs. This article summarizes the pharmacologic and physiologic data relevant to understanding the basic pathophysiology associated with pseudocholinesterase deficiency and illustrates a case study of a young woman suspected of having the disorder after a prolonged delay in emergence from general anesthesia.
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Research Article| September 29 2020
Pseudocholinesterase Deficiency Considerations: A Case Study
Bryant W. Cornelius, DDS, MBA, MPH;
*Assistant Professor and Program Director of Oral Maxillofacial and Dental Anesthesiology, The Ohio State University College of Dentistry and Wexner Medical Center, Columbus, Ohio
Address correspondence to Bryant W. Cornelius, 2154 Postle Hall, 305 W. 12th Ave, Columbus, OH 43021; email: firstname.lastname@example.org.
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Bryant W. Cornelius, Todd M. Jacobs; Pseudocholinesterase Deficiency Considerations: A Case Study. Anesth Prog 1 September 2020; 67 (3): 177–184. doi: https://doi.org/10.2344/anpr-67-03-16
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