Delayed Recovery After General Anesthesia due to Undiagnosed Pseudocholinesterase Deficiency: A Case Report

Pseudocholinesterase deficiency is a rare pharmacogenetic disorder caused by a defect in the enzyme butyrylcholinesterase, which may result in delayed recovery following exposure to neuromuscular blocking agents such as succinylcholine and mivacurium. Patients with this condition require mechanical ventilation and sedation until they regain muscle strength and can be safely extubated. This report highlights the clinical implications of pseudocholinesterase deficiency and discusses the approach to providing safe and effective anesthesia for affected patients. We present the case of a 61-year-old woman who underwent elective vertebroplasty for a vertebral compression fracture and experienced delayed recovery from general anesthesia with prolonged postoperative apnea, which was subsequently determined to be caused by hereditary pseudocholinesterase deficiency. In conclusion, early recognition of prolonged neuromuscular blockade after general anesthesia due to pseudocholinesterase deficiency is essential for prevent complications and potentially life-threatening outcomes.