pseudocholinesterase deficiency, muscle paralysis, peripheral nerve stimulator, succinycholine
Medicine and Health Sciences | Nursing
Pseudocholinesterase is an enzyme produced in the liver that metabolizes neuromuscular blocking agents, particularly succinylcholine. A deficiency in pseudocholinesterase is typically caused by either a homozygous or heterozygous abnormal genetic variant of the enzyme which leads to a prolonged neuromuscular block and therefore muscle paralysis. It is vital for anesthesia providers to know the mechanism of action and duration of succinylcholine, as well as appropriate assessment and treatment if a pseucholinesterase deficiency is suspected. There is no treatment for a pseudocholinesterase deficiency of a genetic origin, however supportive care, particularly ventilator support, must be provided until the medication has been adequately metabolized and the patient has regained muscle strength as evidenced by adequate ventilatory effort and four strong twitches without fade when stimulated by a peripheral nerve stimulator (Stoelting & Hiller, 2015)
Esselstein, Amanda, "Pseudocholinesterase Deficiency: Implications in Anesthesia" (2016). Master of Science in Nursing (MSN) Student Scholarship. Paper 170.