Pseudocholinesterase deficiency in a octogenarian undergoing total intravenous anesthesia; implications for neuromonitoring

Matthew Wecksell, Demetri Koutsospyros

Research output: Contribution to journalArticle

3 Scopus citations


Pseudocholinesterase deficiency manifests as prolonged motor blockade after the administration of succinylcholine. A previously unknown homozygous form of the disease, became apparent during a lumbar laminectomy seriously limiting the ability to monitor motor evoked potentials and perform electromyelography (EMG). Moreover, concerns were raised as to how the enzyme deficiency would affect the metabolism of remifentanil and other esters during a total intravenous anesthetic. We present the perioperative management of the patient and a literature review of the syndrome. The patient provided written permission for the authors to publish this report. At our institution, IRB review and approval is not required for a single case report.

Original languageEnglish (US)
Pages (from-to)157-162
Number of pages6
JournalMiddle East Journal of Anesthesiology
Issue number2
StatePublished - Jun 1 2015


ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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