Nursing-Patient did not wake after Anesthesia

[xdrowe]

Good afternoon everyone, I am curious about this issue. I had 2 surgeries when I was 18 but it wasn't until a surgery in my 20s that I realized the risk factor in not waking after general anesthesia, are there any medical professionals that have witnessed this happening with a patient. If so, do you mind talking about it. Was there a reason that it happened, and what was the protocol for dealing with a patient when it does happen? All words are welcomed.

[xdrowe]

Ummm, yes. Have managed many such cases.

Ok.. do you mind sharing?

[roser13, ASN, RN]

18 year old having his first surgery. On arrival in PACU, patient failed to resume any motor function, despite having been reversed. HR & BP increased, Anesthesia back to bedside. Patient fit the criteria for pseudocholinesterase deficiency, re-intubated in PACU and placed on vent. I had him one on one for 8 hours, keeping him sedated with versed & propofol, using the BIS monitor to measure level of sedation.

When motor function started appearing, we gradually decreased the sedation and patient recovered as usual. Turns out that Dad had a relative to whom the same thing had happened, but dad had not been asked any pre-op questions. Our pre-op clinic was initiated in the next year and to date, we have not had another incident of of PD. Prior to the pre-op clinic, we had at least 1-2 cases annually.