Pseudocholinesterase Deficiency

Excerpt

Pseudocholinesterase deficiency, also known as butyrylcholinesterase deficiency, refers to a rare acquired or inherited defect in the pseudocholinesterase enzyme produced by the liver. In clinical anesthesia practice, the muscle relaxants succinylcholine and mivacurium are drugs used to optimize intubating conditions and surgical exposure. The drugs succinylcholine and mivacurium are both metabolized by the pseudocholinesterase enzyme. Patients with defective forms of pseudocholinesterase will have a reduced ability to metabolize these two muscle relaxants and will present with prolonged muscular paralysis from standard doses of succinylcholine and mivacurium.