Suxamethonium Apnea: A Rare but Challenging Case to Come across as Anaesthetists

Suxamethonium (succinylcholine) apnoea occurs when a patient has been given the muscle relaxant suxamethonium, but does not have the enzymes to metabolise it. They remain paralysed for an increased length of time and cannot breathe adequately at the end of an anaesthetic. It can be inherited or appear spontaneously in a person with no family history. In cases where suxamethonium apnoea is inherited, the level of plasma cholinesterase is reduced. In the acquired condition, the level of plasma cholinesterase is normal but its activity is reduced.