[Prolonged neuromuscular block after administration of mivacurium caused by plasma psueudocholinesterase deficiency].
Mivacurium is a new neuromuscular blocking agent with a short acting time of about 30 min, due to a fast hydrolysis by pseudocholinesterases. This metabolism carries a risk for prolonged neuromuscular block in case of an acquired or congenital pseudocholinesterase deficiency. We report the case of a 75-year-old woman who experienced a neuromuscular block prolonged for 10 h after a single dose of 0.35 mg.kg-1 of mivacurium, because of a major pseudocholinesterase (1800 UI.L-1, normal value: 5400-13200 UI.L-1). The likely cause was a congenital deficiency by a homozygote genetic mutation, as usual causes of an acquired deficiency had been eliminated.
Kaiser
E
E
Département d'Anesthésie-Réanimation-Centre de brûlés, Hôpital d'Instruction des Armées Sainte-Anne, Toulon Naval.
Petit
D
D
Quinot
J F
JF
Suppini
A
A
Sallaberry
M
M
D000368:Aged; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods; D002091:Butyrylcholinesterase / Q000097:blood / Q000172:deficiency*; D003677:Deficiency Diseases / Q000151:congenital; D005260:Female; D006720:Homozygote; D006801:Humans; D007044:Hysterectomy; D007546:Isoquinolines / Q000378:metabolism* / Q000494:pharmacology; D000077590:Mivacurium; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000378:metabolism* / Q000494:pharmacology
D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D002091:Butyrylcholinesterase
Curarisation prolongée après mivacurium par déficit en pseudocholinestérases plasmatiques.