Understanding Anesthesiology - The Global Regional Anesthesia ...

• Pseudocholinesterase deficiency. Deficiency can result
as a genetic defect, as a consequence of various
medications or a result of liver disease. The latter
two causes are usually relative while the genetic defect
can produce a complete lack of pseudocholinesterase
activity in homozygous individuals. The use
of succinylcholine in a patient with pseudocholinestersase
deficiency leads to prolonged paralysis.
• Hyperkalemia.
• Presence of neurologic or muscular condition which
would predispose to hyperkalemia after Sch-induced
muscle contraction. Examples include recent paralysis
(spinal cord injury or stroke), amyotrophic lateral
sclerosis (ALS), Duchenne’s muscular dystrophy and
recent burn or crush injury. Myotonia congenita or
myotonia dystrophica can manifest sustained contraction
with Sch.
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