Master of Science in Nursing (MSN) Student Scholarship

Date Written

Fall 2014

Document Type


Course Number

NURS 5330

Course Name

Advanced Pathophysiology

Professor’s Name

John D. Chovan, James R. Cacchillo


Anesthesia, Patient Outcomes

Subject Categories

Anesthesiology | Medical Pathology | Nursing


Pseudocholinesterase deficiency is a rare genetic or acquired variation in the metabolism of choline esters such as the neuromuscular blockers succinylcholine, mivacurium, and ester local anesthetics. Pseudocholinesterase deficiency genetically is transmitted in an autosomal recessive pattern with the frequency of apnea from a genetic abnormality of pseudocholinesterase between 1:480 and 1:3200 people (Ok et al., 2013). An extended period of neuromuscular blockade results from these medications than what is clinically expected. The signs and symptoms which occur are apnea and paralysis hours longer. This condition is rare but must be known and understood by the clinician in order to provide the safest patient care possible. The information is not widely known or readily available and usually is undetected until the patient receives the medications and then the neuromuscular blockade continues well beyond the expected duration. The purpose of this discussion is to further educate the practitioner on the pathophysiology of pseudocholinesterase deficiency, as well as signs and symptoms, and patient management strategies to improve patient outcomes.



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