A Case of Pseudocholinesterase Deficiency in the PACU

A 39-year-old patient with unrecognized atypical pseudocholinesterase was given succinylcholine during the rapid-sequence induction process and subsequently had a prolonged neuromuscular blockade. The patient was reassured, sedated, and ventilated in the postanesthesia care unit (PACU). The primary nursing interventions included airway clearance, communication, comfort, and patient education. Several important learning experiences occurred for the nurses in the PACU related to identifying possible causes, ordering the pseudocholinesterase and dibucaine inhibition test, interpreting the results, and developing and delivering patient education. This article will provide the perianesthesia nurse with the fundamental understanding of the physiology, laboratory diagnostic interpretation, and nursing interventions needed to deliver evidence-based, high-quality care to patients diagnosed with pseudocholinesterase deficiency.