Abstract
The detailed clinical response of a patient with absent plasma cholinesterase (genotype1 s Ef) who received tubocurarine (3 mg), succinylcholine (120 mg), pancuronium (2mg), and reversal with neostigmine (3 mg) is reported. The patient–s responses were compared to the responses of a group of patients with genotype El a El a evaluated prospectively, and with eight other genotype El s El s patients reported in the literature. The present patient demonstrated evidence of a phase II block before and after attempted reversal, suggesting that free succinylcholine was present in her plasma and a mixed block was present at that time. Conservative supportive therapy was continued and a complete recovery resulted five hours and 30 minutes after the succinylcholine administration.
Résumé
La réponse clinique détaillée d’une patiente présentant une absence de cholinestérase plasmatique (génotype E1 s E1 s J qui a recu de la tubocurarine (3 mg), succinylcholine (120 mg), pancuronium (2 mg), et renversee par néostigmine (3 mg), est rapportée. Les réponses de la patiente ont été comparées avec les réponses d’un groupe de patients présentant un génotype E1 a E1 a évalués prospectivement ainsi qu’avec huit autres présentant un génotype E1 aE1 a rapportés dans la littérature. La patiente adémontré de l’évidence d’un bloc phase II avant et après une tentative de renversement du bloc, suggérant que la succinylcholine libre était présente dans son plasma et qu’un bloc mixte était présent en même temps. Une thérapie conservatrice de support était continuée et un rétablissement complet s’en est suivi cinq heures et trente minutes après l’administration de succinylcholine.
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Dykes, M.H.M., Cheng, SC., Cohen, H. et al. Multiple neuro-muscular blocking agents and reversal in a patient with absent plasma cholinesterase. Can Anaesth Soc J 33, 657–661 (1986). https://doi.org/10.1007/BF03014273
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DOI: https://doi.org/10.1007/BF03014273