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Prolonged paresis in a primigravida during and after caesarean section
T Mekbib1, Z D Djabirov, A Simon
1Department of Obstetrics and Gynaecology, Addis Ababa, Ethiopia.
Ethiopian Medical Journal
|October 1, 1990
Summary
A rare complication of anesthesia, prolonged muscle relaxation occurred due to low plasma cholinesterase (PCE) activity. This highlights the importance of considering PCE deficiency when succinylcholine is used, especially in certain populations.
Area of Science:
- Anesthesiology
- Biochemistry
Background:
- Succinylcholine is a common muscle relaxant used in general anesthesia.
- Its metabolism is primarily dependent on plasma cholinesterase (PCE) activity.
- Reduced PCE activity can lead to prolonged neuromuscular blockade.
Observation:
- A primigravida experienced prolonged muscle relaxation and respiratory depression for four hours post-Caesarean section.
- Assisted respiration was required during this period.
- The patient underwent a Caesarean section due to cervical dystocia and relative cephalo-pelvic disproportion.
Findings:
- The prolonged relaxation was attributed to decreased plasma cholinesterase (PCE) activity.
- This reduced PCE activity impaired the breakdown of succinylcholine.
- The exact incidence of PCE deficiency in the local population is unknown.
Implications:
- Anesthesiologists should consider the possibility of PCE deficiency in cases of prolonged neuromuscular blockade.
- Succinylcholine use requires careful monitoring, especially in populations with potentially higher rates of enzyme deficiency.
- Awareness of this complication is crucial for patient safety in surgical settings using succinylcholine.