Quantitative Neuromuscular Monitoring Permits Early Diagnosis of Abnormal Butyrylcholinestrase: Two Case Studies Demonstrating Prevention of Awareness from Premature Awakening.
AANA J
; 92(2): 139-143, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38564210
ABSTRACT
Administration of succinylcholine to patients with a variant in the butyrylcholinesterase (BChE) gene increases the risk of anesthesia emergence prior to recovery from neuromuscular blockade (NMB). Application of quantitative neuromuscular monitoring (NMM) can identify residual NMB. We present two patients with abnormal BChE gene variants. In the first case, quantitative monitoring was applied too late to prevent awareness, but allowed diagnosis and prevented admission to the intensive care unit. In the second case, monitoring was applied prior to NMB, which enabled early diagnosis and prevented premature awakening from anesthesia. These cases illustrate the importance of quantitative NMM, even in short cases and with short-acting depolarizing agents such as succinylcholine. The clinical implications of this report include a more consistent use of NMM to identify and manage patients with undiagnosed abnormal BChE and to prevent premature anesthesia emergence.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Butirilcolinesterasa
/
Anestesia
Límite:
Humans
Idioma:
En
Revista:
AANA J
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Estados Unidos