title: A prospective study of serum pseudocholinesterase levels in patients with chronic spinal pain: a preliminary study.
abstract: METHODS
  One-dimensional polyacrylamide gel electrophoresis was used to study serum esterase enzymatic activity in three groups of patients and one group of normal volunteers.
  
  
  OBJECTIVE
  To determine whether there is a statistically significant correlation between variations of serum pseudocholinesterase and the perception of pain in patients with chronic spinal pain.
  
  
  BACKGROUND
  Changes in levels of cholinesterase in the extracellular space of the brain and in the cerebral spinal fluid have been found to be associated in animal pain experimentation.
  
  
  METHODS
  Ninety-three surgical patients with chronic spinal pain, six surgical control subjects operated for conditions not associated with pain, 21 normal control volunteers, and nine disabled patients receiving monetary benefits were studied. The patients were analyzed for a period of time by rating the perception of their pain with a visual assessment score at the time venous blood was drawn. Serum samples were prepared, serum pseudocholinesterase was monitored, separated, and quantified according to Allen et al.5 Paired sample t tests were used to statistically evaluate the data.
  
  
  RESULTS
  A trend of correlation was noted between preoperative serum pseudocholinesterase levels and visual assessment score: serum pseudocholinesterase levels increased as visual assessment score increased. The mean preoperative serum pseudocholinesterase level of chronic spinal pain patients (1313; SE = 26), which was significantly higher than the mean levels of the normal control volunteers (941; SE = 24; P<0.001) and that of surgical control subjects (1018; SE = 63; P <0.01), decreased significantly with anesthesia (P<0.005). The mean preoperative serum pseudocholinesterase level of the surgical controls, however, remained unchanged with anesthesia. A correlation demonstrated between visual assessment score and serum pseudocholinesterase in chronic spinal pain patients was not observed in six of nine patients receiving disability payments for more than a year.
  
  
  CONCLUSIONS
  Measurements of quantitative alterations of serum pseudocholinesterase levels may be useful in the treatment of patients with chronic spinal pain.
authors.affiliation: Saint Luke's Episcopal Hospital, Center for Orthopaedic Research and Education, Houston, Texas 77225-0269, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Cameron
authors.forename: R C
authors.initials: RC
authors.lastname: Allen
authors.forename: C
authors.initials: C
authors.lastname: Merril
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000097:blood / Q000201:enzymology* / Q000601:surgery; D002091:Butyrylcholinesterase / Q000097:blood*; D002908:Chronic Disease; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D002091:Butyrylcholinesterase