1. Clinical importance of plasma cholinesterase for the anaesthetist.
- Author
-
Pedersen NA and Jensen FS
- Subjects
- Anesthesiology, Cholinesterases genetics, Cholinesterases metabolism, Female, Genotype, Humans, Isoquinolines metabolism, Isoquinolines pharmacology, Male, Mivacurium, Neuromuscular Nondepolarizing Agents metabolism, Neuromuscular Nondepolarizing Agents pharmacology, Phenotype, Prodrugs metabolism, Prodrugs pharmacology, Succinylcholine pharmacology, Terbutaline analogs & derivatives, Terbutaline metabolism, Terbutaline pharmacology, Cholinesterases blood, Succinylcholine metabolism
- Abstract
Plasma cholinesterase is a glycoprotein synthesized in the liver and is found in plasma, liver, intestinal mucosa and other tissues. Six percent to 7% of patients in most surgical populations have an abnormal plasma cholinesterase activity and about 65% of all cases of prolonged neuromuscular blockade following succinylcholine are due to genetic factors. This review focuses on the causes and clinical significance of plasma cholinesterase for the hydrolyses of succinylcholine. Diagnosis and treatment of prolonged response to succinylcholine in phenotypically normal patients, heterozygous abnormal patients and patients homozygous for the atypical gene is mentioned. Also presented is the relationship between plasma cholinesterase and the new relaxant mivacurium, and bambuterol, a prodrug to terbutaline. Additionally, the recent developments in the identification of the plasma cholinesterase genotypes are presented.
- Published
- 1994