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Case Report

Open Access

An Unusual Cause of Recurrent Laryngeal Nerve Monitoring Failure during Parathyroidectomy

  • KATARINA BOJANIĆ1
  • AMANDA R. MORASKA2
  • JURAJ SPRUNG3
  • GEOFFREY B. THOMPSON4
  • TOBY N. WEINGARTEN 5

1,Resident in Pediatrics (Research Trainee at Mayo Clinic)

2,Mayo Clinic Medical Student

3,Professor of Anesthesiology

4,Professor of Surgery

5Assistant Professor of Anesthesiology From the Department of Anesthesiology and Department of Surgery College of Medicine, Mayo Clinic

DOI: 10.22514/SV62.102011.13 Vol.6,Issue 2,October 2011 pp.86-88

Published: 31 October 2011

*Corresponding Author(s): TOBY N. WEINGARTEN E-mail: weingarten.toby@mayo.edu

Abstract

Intraoperative monitoring of the recurrent laryngeal nerve (RLN) during surgical dissection allows for real time identification and assessment of nerve function integrity. Since neuromuscular blockade interferes with electromyography, long-acting muscle relaxants cannot be used during anesthesia. We report a patient in whom monitoring of the RLN was unsuccessful because of prolonged muscle paralysis following the administration of succinylcholine, presumably due to a pseudocho-linesterase deficiency.

Keywords

laryngeal nerve monito-ring, muscle paralysis, pseudocholi-nesterase deficiency

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KATARINA BOJANIĆ,AMANDA R. MORASKA,JURAJ SPRUNG,GEOFFREY B. THOMPSON,TOBY N. WEINGARTEN . An Unusual Cause of Recurrent Laryngeal Nerve Monitoring Failure during Parathyroidectomy. Signa Vitae. 2011. 6(2);86-88.

References

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2. Harada T, Shimonaka H, Yamamoto M, Akamatsu S, Kasamatsu M, Gotoh M, et al. Succinylcholine neuromuscular blockade in a case of pseudocholinesterase variant. Masui 1989;38:791-6.

3. Viby-Mogensen J. Succinylcholine neuromuscular blockade in subjects homozygous for atypical plasma cholinesterase. Anesthesiology 1981;55:429-34.

4. Whittaker M. Plasma cholinesterase variants and the anaesthetist. Anaesthesia 1980;35:174-97.

5. Harris H, Whittaker M. Differential inhibition of human serum cholinesterase with fluoride: recognition of two new phenotypes. Nature 1961;191:496-8.

6. Soliday FK, Conley Y, P., Henker R. Pseudocholinesterase deficiency; A comprehensive review of genetic, acquired, and drug influences. AANA Journal 2010;78:313-20.

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