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.

Highlights

  • Intraoperative monitoring of the recurrent laryngeal nerve (RLN) with electromyography improves precision in identification of the RLN and provides immediate electromyographic feedback regarding its integrity during surgical dissection

  • 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 pseudocholinesterase deficiency

  • We report a patient in whom intraoperative monitoring of the RLN was unsuccessful because of unrecognized prolonged muscle paralysis following the administration of succinylcholine, presumably due to one of the variants of pseudocholinesterase (PsChE) deficiency

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Summary

CASE REPORT

An Unusual Cause of Recurrent Laryngeal Nerve Monitoring Failure during Parathyroidectomy. WEINGARTEN ( ) Assistant Professor of Anesthesiology From the Department of Anesthesiology and Department of Surgery College of Medicine, Mayo Clinic, 200 First

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