[Plasma cholinesterase and abnormal reaction to suxamethonium injection. 20-year experience with the Danish Cholinesterase Registry].
For more than 20 years, the Danish Cholinesterase Research Unit (DCRU) has collected information about patients showing an abnormal response to succinylcholine. The purpose of this study was to evaluate our clinical findings in patients referred because of prolonged response following succinylcholine. Also, we wanted to evaluate the results of our prospective controlled studies of the effect of succinylcholine in patients with normal and abnormal plasma cholinesterase genotypes. An explanation for the apparent abnormal response to succinylcholine was only found in roughly 60% of the 1247 patients referred to the Unit. In the remaining nearly 40% of the patients the reason for the abnormal response remained obscure, though our results indicate that the anaesthetic technique, including hyperventilation or central respiratory depression, was most likely to be the reason. The significance of the different genotypes, including two newly discovered genotypes (AK, AH), for the reaction to succinylcholine was evaluated and found to be comparable to previous findings. Our results indicate that it is a problem for many anaesthetists to correctly diagnose a prolonged response to succinylcholine. We therefore urge the anaesthetist to use a peripheral nerve stimulator when faced with a case of apparent abnormal response to succinylcholine.
Jensen
F S
FS
Dansk Kolinesterase Kartotek, anaestesi-og intensivafdelingen, Rigshospitalet, København.
Mogensen
J V
JV
D002802:Cholinesterases / Q000097:blood* / Q000235:genetics; D005838:Genotype; D006801:Humans; D007275:Injections, Intravenous; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D013390:Succinylcholine / Q000008:administration & dosage* / Q000009:adverse effects
D009467:Neuromuscular Depolarizing Agents; D002802:Cholinesterases; D013390:Succinylcholine
Plasmakolinesterase og unormal reaktion på injektion af suxamethon. Tyve års erfaring med Dansk Kolinesterase Kartotek.