After suxamethonium 50mg, apnea persists for one hour --
Suxamethonium is a depolarising muscle relaxant used to rapidly gain optimal intubating conditions. It is normally metabolised within 5 minutes by plasma cholinesterase. Some patients lack this enzyme or have an altered enzyme that does not metabolise the suxamethonium as rapidly. These patients may remain paralysed for a prolonged period after a standard dose of suxamethonium and rely on renal elimination. This condition is often referred to as suxamethonium apnea
treatment with cholnesterase is indicated
Probably an atypical cholinesterase is present
Treatment with stored blood is indicated
Apnea may be due to low serum potassium concentration
Muscle relaxants