Suxamethonium and mivacurium sensitivity from pregnancy‐induced plasma cholinesterase deficiency

A 25‐year‐old man admitted with severe upper torso trauma displayed masseter muscle spasm after suxamethonium given during resuscitation. Anaesthesia was initially maintained with intravenous agents during transfer and X‐ray angiography. However, during surgery to correct a brachial artery injury, malignant hyperthermia was triggered when isoflurane was given, 2.5 h after the suxamethonium. He responded to treatment, including dantrolene administration. Peak serum and urine myoglobin were 12 947 μg.l−1 and 54 571 μg.l−1, respectively, while maximum serum creatinine kinase was 17 300 IU. The patient made an uneventful recovery and later proved positive for malignant hyperthermia susceptibility on muscle contracture tests.

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