[Residual relaxant block due to pseudocholinesterase deficiency - First manifestation in an elderly patient]

Area of Science:

• Anesthesiology
• Biochemistry

Background:

• Pseudocholinesterase (BChE) is crucial for metabolizing neuromuscular blocking agents like mivacurium and suxamethonium.
• Reduced BChE activity can lead to prolonged effects of these anesthetic drugs.

Observation:

• A 65-year-old patient undergoing elective surgery was found to have previously undiagnosed BChE deficiency.
• The deficiency was identified during the surgical procedure.

Findings:

• The patient's BChE deficiency was diagnosed intraoperatively.
• Neuromuscular monitoring is essential for detecting and managing such deficiencies.

Implications:

• Early diagnosis of BChE deficiency is vital for preventing prolonged paralysis and mechanical ventilation.
• This case underscores the critical role of neuromuscular monitoring in anesthetic practice for patient safety.