Expert: Dr Ian Jackson - please note UK based - 1/19/2010

Question
Had surgery in 1989 took over 8 hrs to be removed from ventilation. In 1993 had another surgery, but informed the anaestheologist that I did not metabolize succinocholine very well. He used another procedure so I could be safely vented, and it worked fine. Last year I had to go in for emergency surgery. The surgeon and the anaestheologist were both made aware of my problem with scuccinocholine. I ended up vented for 7 days in intensive care after the surgery. They could not get me to breath on my own till then. Can you suggest a method for me to be safely vented. I will carry that information in my wallet, inform my family members and make sure it is included in my medical records.  

Answer
Hi there
This shouldn't really be an issue as it is usually easy to avoid suxamethonium and the other drug that can cause an issue mivacurium. The fact that you had emergency surgery may have prompted them to use suxamethonium for your own safety, however it is unusual for someone to stay on the ventilator for 7 days so it sounds like you were very sick and so there were more factors coming into play.
The important info is to carry that you have pseudocholinesterase deficiency - there are alternative drugs that can be used in an emergency but I would never suggest that you carry those details around. It is really up to the clinicians who are dealing with you to use the drugs and techniques that will be safest - sometimes that will mean using suxamethonium.
Just so you know the closest alternative to giving the speed of onset and conditions provided by sux is a drug called rocuronium.
Anyway I hope the above helps
Kind regards
Dr Ian Jackson