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Pseudocholinesterase Deficiency in Ambulatory Surgery: A Case Report
Elizabeth Johnson-Gray1, Austin J Shaffer1, Priyanka Pandey2
1Anesthesiology, OhioHealth Doctors Hospital, Columbus, USA.
Cureus
|April 14, 2025
Summary
Pseudocholinesterase (PCHE) deficiency causes prolonged paralysis after anesthesia. This case highlights PCHE deficiency diagnosed after a patient required prolonged mechanical ventilation post-surgery.
Area of Science:
- Anesthesiology
- Pharmacogenetics
Background:
- Pseudocholinesterase (PCHE) deficiency is a rare genetic disorder affecting muscle relaxant metabolism.
- Individuals with PCHE deficiency exhibit prolonged paralysis when exposed to specific anesthetic agents like succinylcholine and mivacurium.
Observation:
- A 53-year-old male patient, with a history of post-operative nausea and vomiting, underwent robotic inguinal hernia repair.
- The patient experienced prolonged paralysis and inability to be extubated in the operating room (OR).
Findings:
- The patient was diagnosed with Pseudocholinesterase (PCHE) deficiency post-operatively.
- Diagnosis was confirmed by the patient's prolonged response to neuromuscular blocking agents.
Implications:
- This case underscores the importance of considering PCHE deficiency in unexplained prolonged paralysis after anesthesia.
- Early recognition and management are crucial for patient recovery and preventing prolonged mechanical ventilation.
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