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CASE REPORT
Year : 2011  |  Volume : 27  |  Issue : 2  |  Page : 247-248

Donepezil: A cause of inadequate muscle relaxation and delayed neuromuscular recovery


Department of Anaesthesia and Critical Care Medicine, Maulana Azad Medical College and Lok Nayak Hospital, Jawaharlal Nehru Marg, New Delhi - 110 002, India

Correspondence Address:
Alka Bhardwaj
Department of Anaesthesia and Critical Care Medicine, Maulana Azad Medical College and Lok Nayak hospital, Jawaharlal Nehru Marg, New Delhi - 110 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.81833

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A 74-year-old female with diabetes mellitus type II and Alzheimer's disease, taking donepezil for 4 months was operated for right modified radical mastectomy under general anesthesia. During the procedure a higher dose of non-depolarizing muscle relaxant was required than those recommended for her age yet the muscle relaxation was inadequate intra-operatively. Residual neuromuscular blockade persisted postoperatively, due to the cumulative effect of large doses of non-depolarizing muscle relaxant, needing post-operative ventilatory assistance. After ruling out other causes of resistance to non-depolarizing muscle relaxants, we concluded that acetylcholinesterase inhibitor donepezil was primarily responsible for inadequate muscle relaxation and delayed post-operative neuromuscular recovery.


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