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Article Contents

  • CASE STUDY
  • PHYSIOLOGY OF THE NEUROMUSCULAR JUNCTION
  • PHARMACOLOGY OF NEUROMUSCULAR BLOCKERS
  • DISCUSSION
  • CONCLUSION
  • REFERENCES
  • CONTINUING EDUCATION QUESTIONS
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Pseudocholinesterase deficiency, sometimes called butyrylcholinesterase deficiency, is a rare disorder in which the neuromuscular blocking drugs succinylcholine and mivacurium cannot be metabolized properly in the blood plasma. This disorder can either be acquired as a result of certain comorbidities or it can be inherited genetically. Anesthesia providers must understand the pathophysiology of pseudocholinesterase deficiency and be prepared to safely and effectively manage patients who show signs and symptoms consistent with the disorder after the use of the indicated neuromuscular blocking drugs. This article summarizes the pharmacologic and physiologic data relevant to understanding the basic pathophysiology associated with pseudocholinesterase deficiency and illustrates a case study of a young woman suspected of having the disorder after a prolonged delay in emergence from general anesthesia.

Keywords: Pseudocholinesterase deficiency; Butyrylcholinesterase deficiency; Residual neuromuscular blockade; Delayed emergence; General anesthesia
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Copyright: © 2020 by the American Dental Society of Anesthesiology
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Article Contents

Perioperative Management of a Patient With Idiopathic Pulmonary Hypertension and a History of Syncope: A Case Report

Aiji Sato (Boku) DDS, PhD;,
 MinHye So MD, PhD;,
 Kazuma Fujikake MD, PhD;,
 Motoshi Tanaka MD;,
 Yuji Kamimura MD, PhD;,
 Haruko Ota MD, PhD;,
 Tomomi Mizutani DDS,
 Kenichiro Ishibashi DDS, PhD;,
 Yasuyuki Shibuya DDS, PhD;, and
 Kazuya Sobue MD, PhD

How Safe Is Anesthesia Management by Dentist Anesthesiologists? The Need for an International Collaborative Study on the Safety of Anesthesia Management by Dentist Anesthesiologists

Takuro Sanuki DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD, and
 Naotaka Kishimoto DDS, PhD

General Anesthetic Management of a Patient With Spondyloepiphyseal Dysplasia Congenita Undergoing Palatoplasty Revision

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 Aiji Sato (Boku) DDS, PhD,
 Mayuko Kanazawa DDS, PhD,
 Erika Harada DDS,
 Mami Asai DDS,
 Yuko Shikama DDS,
 Hiroko Kobayashi DDS,
 Makoto Hirohata DDS,
 Naoko Tachi DDS, PhD, and
 Masahiro Okuda MD, PhD
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