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Correlation of Plasma Cholinesterase Activity and Duration of Action of Succinyicholine During Pregnancy

CASEY D. BLITT, MD^*, W. CLAYTON PETTY, MD, EVA E. ALBERTERNST, CRNA, and BARBARA J. WRIGHT

*Assistant Professor, Department of Anesthesiology, University of Arizona Medical Center, Tucson, Arizona 85724. Attending Anesthesiologist, Dixie Hospital, St. George, Utah. Nurse Anesthetist, University of Arizona Medical Center. Research Assistant, University of Arizona Medical Center.

Abstract

Correlation between plasma cholinesterase activity and duration of neuromuscular blockade following succinylcholine (SCh) was studied in 30 healthy women undergoing laparoscopictubal coagulation and 20 pregnant women undergoing elective repeat cesarean section. All patients received N₂O-thiopental anesthesia. Cholinesterase activity in nonpregnant patients was significantly greater than in pregnant patients. Time to 90 percent recovery of control twitch height following 40 or 80 mg/m² BSA of SCh was not significantly different in pregnant versus nonpregnant patients. There also was no correlation between plasma cholinesterase activity and duration of paralysis from SCh. The authors conclude that pregnant patients have lower cholinesterase activity, but prolonged neuromuscular blockade from SCh should not occur unless the patient is grossly overdosed with SCh. Routine use of a peripheral nerve stimulator is recommended to avoid such overdosage.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999