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Suxamethonium apnoea and the isolated leg
Author(s) -
MITCHELL J. B.,
HARROPGRIFFITHS W.
Publication year - 1994
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1994.tb14182.x
Subject(s) - medicine , tourniquet , anesthesia , neuromuscular junction , surgery , biology , neuroscience
Summary The anaesthetic management of a patient with an unsuspected homozygous atypical pseudocholinesterase genotype is described. Suxamethonium was administered after an arterial tourniquet had been applied to the patient's right leg. After release of the tourniquet and termination of the anaesthetic it was noted that the patient was able to move his right leg but no other part of his body. This observation was confirmed by the use of a peripheral nerve stimulator and by the patient's own recollections. It is suggested that this occurrence shows that the slow offset of neuromuscular block in patients with atypical pseudocholinesterases who have received suxamethonium is caused by long lasting effects at the neuromuscular junction rather than the continuing presence of suxamethonium in the plasma.