Prolonged curarisation following succinylcholine injection on butyrylcholinesterase deficiency and potentiated by a lithium treatment: a case report

• Published in: Annales de biologie clinique (Paris) Vol. 71; no. 4; p. 485
• Main Authors: Huynh-Moynot, Sophie, Moynot, Jean-Clair, Thill, Chloé, Commandeur, Diane, Ould-Ahmed, Mehdi, Drouillard, Isabelle
• Format: Journal Article
• Language: French
• Published: France 01-07-2013
• Subjects: Aged; Apnea; Bipolar Disorder - drug therapy; Bronchoscopy - methods; Butyrylcholinesterase - deficiency; Drug Synergism; Humans; Intubation, Intratracheal; Lithium Compounds - adverse effects; Lung Neoplasms - diagnosis; Male; Metabolism, Inborn Errors - complications; Neuromuscular Blockade - adverse effects; Neuromuscular Depolarizing Agents - adverse effects; Succinylcholine - adverse effects; Time Factors; lithium; sevoflurane; butyrylcholinesterase; pseudocholinesterase; paraneoplastic syndrome
• ISSN: 1950-6112
• DOI: 10.1684/abc.2013.0865

Succinylcholine is a short-term curare which degradation depends on its quick hydrolysis by butyrylcholinesterase (or pseudocholinesterase). Thus, a butyrycholinesterase deficiency, congenital or acquired, is a cause of a prolonged neuromuscular block. From an autosomal recessive inheritance, genetic deficiency remains the first etiology. The most frequently discussed variant is the atypical variant which caused a 2 hours prolonged curarisation after administration of succinylcholine. We report a patient who had a prolonged curarisation after succinylcholine's injection, due to a congenital butyrylcholinestérase deficiency and contributed by a lithium treatment. Extubation was only possible 7 hours after administration of curare.