Prolonged Apnea Due To Kongenıtal Pseudocholınesterase Defıcıency In A Two Years Old Chıld

Abstract

Mivacurium nondepolarizing neuromusculer blocking agent hydrolyzed by plasmacholinesterase, especially used for endotracheal intubation for short time surgeries. In this article a case of prolonged apnea after mivacurium administration pseudocholinesterase deficiency (serum level of pseudocholinesterase was 1658 IU/L, normal: 4000-11.000 IU/L) was reported

Mivacurium nondepolarizing neuromusculer blocking agent hydrolyzed by plasmacholinesterase, especially used for endotracheal intubation for short time surgeries. In this article a case of prolonged apnea after mivacurium administration pseudocholinesterase deficiency (serum level of pseudocholinesterase was 1658 IU/L, normal: 4000-11.000 IU/L) was reported

Keywords

• Mivacuryum
• deficiency
• prolonged apnea pseudocholinesterase

İKİ YAŞINDAKİ BİR ÇOCUKTA KONJENİTAL PSÖDOKOLİNESTERAZ ENZİM EKSİKLİĞİNE BAĞLI UZAMIŞ APNE

Abstract

Mivakuryum, plazma kolinesterazı tarafından hidrolize edilen klinik uygulamalarda özellikle endotrakeal entubasyon düşünülen kısa cerrahilerde sıklıkla tercih edilen kısa etkili nondepolarizan nöromuskuler bir ajandır. Bu makalede, genel anestezide mivakuryum uygulanımı sonrası uzamış apne gelişen ve konjenital psödokolinesteraz eksikliği (serum düzeyi 1658 IU/L, normal: 4000-11.000 IU/L) tespit edilen olgu sunulmuştur.Mivakuryum, klinik uygulamalarda özellikle endotrakeal entubasyon düşünülen kısa cerrahi işlemlerde sıklıkla tercih edilen ve plazma kolinesterazı tarafından hidrolize edilen kısa etkili nöromuskuler bir ajandır. Mivakuryum bir benzil izokinolin türevidir. İndüksiyon ajanı olarak verildiğinde 0,2 mg/kg-1 dozunda 2-2,5 dakikada trakeal entübasyon için uygun kas gevşemesini sağlar.

Keywords

• Mivakuryum
• psödokolinesteraz eksikliği
• uzamış apne

References

1. Frampton JE, McTavish D: Mivacurium. A review of its pharmacology and therapeutic
2. potential in general anaesthesia. Drugs 1993;45:1066-89
3. Savarese JJ, Lien CA, Belmont MR, Wastila WB. The clinical pharmacology of new
4. benzylisoquinoline-diester compounds. with special consideration of cisatracurium and
5. mivacurium. Anesthetist. 1997;46:840–9.
6. Ostergaard D, Mogensen JV, Hanel HK, Skovgaard LT. Halflife of plasma cholinesterase.
7. Acta Anaesthesiol Scand. 1988;32:266–9.
8. Musle function and neuromuscular blockade. In Textbook of Anesthesia 4th edition. Edited

9. by: Aitkenhead AR, Rowbotham DJ, Smith G. Spain: Churchill Livingstone; 2001:223-37.
10. Somers R, Jacquemyn Y, Sermeus L, Vercauteren M. Corrected Scoliosis, Cholinesterase
11. Deficiency, and Cesarean Section: A Case Report. Case Report Med. 2009;2009:957479.
12. Savarese JJ, Ali HH, Basta SJ, Embree PB, Scott RP, Sunder N, et al. The clinical
13. neuromuscular pharmacology of mivacurium chloride (BW B1090U). A short-acting
14. nondepolarizing ester neuromuscular blocking drug. Anesthesiology 1988;68(5):723-32.
15. Goudsouzian NG, d'Hollander AA, Viby-Mogensen J: Prolonged neuromuscular block from
16. mivacurium in two patients with cholinesterase deficiency. Anesth Analg 1993;77:183-5.
17. Kayhan Z. Sinir kas iletimi ve kas gevşeticiler. Klinik Anestezi. 3. Baskı. Ankara: Logos
18. Yayıncılık, 2004;151-80.
19. C. L. Leadingham, “A case of pseudocholinesterase deficiency in the PACU,” Journal of
20. Perianesthesia Nursing. 2007; 22(4): 265–74.
21. Zencirci B.Pseudocholinesterase enzyme deficiency: a case series and review of the literature.
22. Cases Journal 2009;2:9148-53.
23. Sockalingam I, Green DW. Mivacurium-induced prolonged neuromuscular block. Br J
24. Anaesth 1995;74(2):234-6.
25. Kaiser E, Petit D, Quinot JF, Suppini A, Sallaberry M. Prolonged neuromuscular block after
26. administration of mivacurium caused by plasma psueudocholinesterase deficiency. Ann Fr
27. Anesth Reanim. 1995;14(6):505-7.
28. Bishop MJ, O'Donnell JT, Salemi JR. Mivacurium and bronchospasm. Anesth Analg.
29. ;97(2):484-5.