Abstract
This case report describes a patient with a personal history of muscle paralysis after emergence from a short general anaesthesia with the use of suxamethonium. She has a partial recall of subsequent intubation.
After a few hours of mechanical ventilation and sedation, she was extubated without complication in the ICU. During the preanesthesia evaluation, we suspected a deficiency of butyrylcholinesterase, an enzyme metabolizing mivacurium and suxamethonium.
Due to that, general anaesthesia with muscle relaxation using rocuronium was performed for a planned hemithyreoidectomy. There were no complications during the surgery and subsequent genetic examinations revealed a combined mutation of the butyrylcholinesterase gene.
Butyrylcholinesterase deficits increase the risk of perioperative respiratory complications. Testing of family members of patients with a confirmed mutation or preventive preoperative examination in high-risk surgery prevent such complications.