A CASE OF OPERATION FOR A CHILD WITH ATYPICAL PSEUDOCHOLINESTERASE

Abstract

Abnomalities in serum cholinesterase (ChE) are rarely reported in Japan. In the past 20 years, 30 cases have been reported and only three of these occurred in children. We experienced a patient presenting with very low ChE levels who had an attack of prolonged apnea over along period following a radical operation on a right external inguinal hernia. The patient was an one-year-old female infant. There was no past or family history and no abnormalities in ordinary tests on admission. Anesthesia was induced by 10 mg of SCC intravenously and was maintained by GOF after intubation. The operating time was 13 minutes, but spontaneus respiration was delayed to appear postopertively. The serum ChE was 1 mu/ml (normal range: 173432 mu/ml) and it took about 3 hours were spontanous respiration appeared. The postoperative course was favorable thereafter. The diagnosis of the disease was suspected from nerve stimulation during anesthesia, and was confirmed by taking blood samples. It appears that a nerve stimulator is effective as a monitor of prolonged apnea.