1/4. Prolonged apnea following succinylcholine administration in undiagnosed acute organophosphate poisoning.organophosphates (OP) are irreversibly bound to cholinesterase, causing deactivation of acetylcholinesterase. As a result of inhibition of plasma cholinesterase, increased sensitivity to drugs hydrolyzed by this enzyme can occur, e.g. succinylcholine and mivacurium. A case of more prolonged succinylcholine-induced paralysis in a child with undiagnosed acute OP insecticide poisoning is presented. A 7-h period of apnea and paralysis after administration of succinylcholine was attributed to the decreased rate of succinylcholine metabolism resulting from inhibition of pseudocholinesterase by the insecticide. In seven previously reported cases of prolonged succinycholine apnea after OP poisoning, exposure to insecticide was in chronic or subacute form without any obvious symptoms, and the duration of apnea did not extend up to 4 h, whereas in our case with acute, severe poisoning, succinylcholine led to more prolonged muscle paralysis. In the anesthetic management of patients with acute OP poisoning, succinylcholine should be avoided.- - - - - - - - - - ranking = 1keywords = organophosphate (Clic here for more details about this article) |
2/4. Prolonged succinylcholine-induced paralysis in organophosphate insecticide poisoning.A case of prolonged succinylcholine-induced paralysis in a child with organophosphate insecticide poisoning is presented. Three hours and 15 minutes of apnea after the administration of succinylcholine was attributed to a decreased rate of succinylcholine metabolism from inhibition of pseudocholinesterase by the insecticide. Only one similar case has been reported previously in the English medical literature. If succinylcholine is to be used in patients with organophosphate poisoning, a prolonged paralysis should be anticipated.- - - - - - - - - - ranking = 1.5keywords = organophosphate (Clic here for more details about this article) |
3/4. Prolonged suxamethonium-induced neuromuscular blockade associated with organophosphate poisoning.We report a patient, exposed to malathion during agricultural work, who suffered a prolonged apnoea after the administration of suxamethonium. He had a normal phenotype (E1u E1u), but an extremely low plasma cholinesterase activity. The diagnosis was made by assaying cholinesterase activity and analysing the enzymic components by electrophoresis on polyacrylamide gel slabs. The results indicated that the apnoea was a result of the low activity of plasma cholinesterase induced by malathion.- - - - - - - - - - ranking = 1keywords = organophosphate (Clic here for more details about this article) |
4/4. Hazards of succinylcholine administration during electrotherapy.We describe prolonged apnea following electrotherapy in a patient who was also being treated with a topical organophosphate anticholinesterase, ecothiophate iodide (phospholine iodide), for glaucoma. The increased duration of action of succinylcholine resulted from low levels of serum cholinesterase that had been caused by the organophosphate. attention is called to other drugs that directly or indirectly (by lowering serum cholinesterase) interact with succinylcholine chloride resulting in prolonged apnea. Other potential hazards of succinylcholine administration, such as hyperkalemia and cardiac arrhythmias, are also discussed.- - - - - - - - - - ranking = 0.5keywords = organophosphate (Clic here for more details about this article) |