Break the Spasm with Succinylcholine, but Risk Intraoperative Awareness with Undiagnosed Pseudocholinesterase Deficiency

Succinylcholine is a commonly used medication in all aspects of anesthetic care, and there are a number of known side effects and complications associated with its use. However, when succinylcholine is used emergently, anesthesia providers must remain vigilant to undiagnosed conditions that pose additional risks to patients. We report the use of succinylcholine to treat acute, refractory laryngospasm after extubation leading to prolonged neuromuscular paralysis. There are unique challenges presented by this case including the risk of anesthesia awareness with recall due to the cognitive biases that prevent the clinical diagnosis of pseudocholinesterase deficiency.

Surgical glue- a promising technology for wound healing

Wound closure is one of the important steps of surgical dressing and suturing is the most commonly used method of wound closure. The process of suturing takes very long time for surgery and increases the patient’s risk of anesthesia awareness. Skin glues are a safe and effective method to close selected wounds. They are also cost-effective and help prevent infection. Ideally, wounds should be less than 4 cm, not contaminated or infected and have skin edges that are not under tension. Wounds should be closed within 12 hours. Novel methods of wound closure have been introduced to address these issues, most notably cyanoacrylate tissue glues. The evidence would suggest that the use of cyanoacrylate tissue glue is associated with a reduction in closure time and costs. On a daily basis, dermasurgeons are facing different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness is preferred.