▁the ▁Eu ▁gene , ▁or ▁other ▁at yp ical ▁gen es ▁( see ▁Pseud och olin ester ase ▁def ic iency ). ▁Such ▁gen es ▁will ▁result ▁in ▁a ▁longer ▁duration ▁of ▁action ▁of ▁the ▁drug , ▁r anging ▁from ▁ 2 0 ▁minutes ▁up ▁to ▁several ▁hours . ▁Ac quired ▁factors ▁that ▁affect ▁pl asma ▁ch olin ester ase ▁activity ▁include ▁pre gn ancy , ▁li ver ▁disease , ▁kid ney ▁failure , ▁heart ▁failure , ▁thy ro to x icos is , ▁and ▁cancer , ▁as ▁well ▁as ▁a ▁number ▁of ▁other ▁dru gs . ▁ ▁If ▁un recogn ized ▁by ▁a ▁clin ician ▁it ▁could ▁lead ▁to ▁aw aren ess ▁if ▁an est hes ia ▁is ▁dis cont in ued ▁whilst ▁still ▁par al yz ed ▁or ▁hy po x emia ▁( and ▁potentially ▁fatal ▁consequences ) ▁if ▁artificial ▁vent ilation ▁is ▁not ▁maintained . ▁Normal ▁treatment ▁is ▁to ▁maintain ▁sed ation ▁and ▁vent il ate ▁the ▁patient ▁on ▁an ▁int ensive ▁care ▁unit ▁until ▁mus cle ▁function ▁has ▁returned . ▁Blood ▁testing ▁for ▁ch olin ester ase ▁function ▁can ▁be ▁performed . ▁ ▁M iv ac ur ium , ▁a ▁non - dep olar izing ▁neur om us cular ▁blocking ▁drug , ▁is ▁also ▁met abol ized ▁via ▁the ▁same ▁route ▁with ▁a ▁similar ▁clin ical ▁effect ▁in ▁patients ▁def ic ient ▁in ▁pl asma ▁ch olin ester ase ▁activity . ▁ ▁D eli ber ate ▁induction ▁of ▁conscious ▁ap nea ▁using ▁this ▁drug ▁led ▁to ▁its ▁use ▁as