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Prolonged paralysis associated with succinylcholine--a case report.

C H Kuo¹, P H Tan, J J Chen

¹Department of Anesthesiology, Kaohsiung Military General Hospital, Kaohsiung, Taiwan, R.O.C.

Acta Anaesthesiologica Sinica

|June 8, 2001

Summary

Prolonged paralysis after surgery is a rare complication. This case highlights how low pseudocholinesterase activity can cause delayed awakening following succinylcholine use during anesthesia for hyperhidrosis treatment.

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Area of Science:

Anesthesiology
Neuromuscular Pharmacology

Background:

Succinylcholine is a common muscle relaxant used in anesthesia.
Prolonged paralysis is a rare but serious adverse effect.
Palmar hyperhidrosis can be treated with transthoracic endoscopic sympathetic ganglionectomy.

Observation:

A patient undergoing surgery for palmar hyperhidrosis experienced prolonged paralysis post-operation.
General anesthesia with facemask was administered.
The paralysis was suspected to be linked to intraoperative succinylcholine administration.

Findings:

Laboratory tests confirmed low pseudocholinesterase activity in the patient.
This enzyme deficiency is a known cause of prolonged succinylcholine-induced paralysis.
The patient's delayed awakening was attributed to this pharmacogenetic finding.

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Implications:

Highlights the importance of considering pseudocholinesterase deficiency in cases of prolonged paralysis.
Informs anesthetic management strategies for patients with potential enzyme deficiencies.
Emphasizes the need for careful patient monitoring and prompt diagnosis of rare anesthetic complications.