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Reaction to succinylcholine in two patients segregating for the plasma cholinesterase allele E k
Author(s) -
Jensen F. S.,
VibyMogensen J.
Publication year - 1992
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1992.tb03558.x
Subject(s) - medicine , anesthesia , cholinesterase , stimulation , myograph , endocrinology , contraction (grammar)
Recently, several new alleles have been identified at plasma cholinesterase locus E 1 . We have had the opportunity for the first time to monitor the response to succinylcholine in two patients with the newly discovered genotype E 1 a E k 1 . The duration of action and type of neuromuscular block following succinylcholine 1.0 and 1.5 mg kg ‐1 i.v., respectively, were evaluated using train‐of‐four nerve stimulation and a Myograph 2000. One patient was anaesthetized with halothane, and the other was given a modified neurolept anaesthesia. Time to first response to nerve stimulation was 15 and 16 min, and time to 50% twitch height recovery was 19 and 20 min, respectively in the two patients. Both showed a depolarizing block. One of the patients received three bolus doses of succinylcholine 1 mg kg ‐1 . This patient gradually developed a phase II block, which was easily reversed by edrophonium. The results indicate that patients with genotype E 1 a E 1 k are slightly more sensitive to succinylcholine than are genotypically normal patients (E 1 u E 1 u ) and patients heterozygous for the normal and the atypical gene (E 1 u E 1 a ).