title: Determination of butyrylcholinesterase (BChE) phenotypes to predict the risk of prolonged apnea in persons receiving succinylcholine in the healthy population of western Iran.
abstract: OBJECTIVE
  The best known clinical application of serum BChE assay is to predict abnormally prolonged apnea following the application of the muscle relaxant succinylcholine. The aim of the present study was to assess the frequency of BChE phenotypes and to predict the risk of apnea for those receiving succinylcholine among the residents in western Iran.
  
  
  METHODS
  We examined the frequency of nine BChE phenotypes in 1548 volunteers including 816 males and 732 females with the mean age of 35+/-15 years from an apparently healthy group living in western Iran. The frequencies of BChE phenotypes were determined using BChE activity measurements and by inhibition with dibucaine, fluoride, and the compound Ro2-0683 (Hoffman-La-Roche).
  
  
  RESULTS
  The reference range for serum total BChE activity was 4600-14000 U/L (using butyrylthiocholine iodide as substrate). The mean value obtained for men (9030 U/L) was significantly (p<0.05) higher than that for women (8550 U/L). The frequencies of four alleles U, A, F, S were calculated to be 0.9826, 0.0165, 0.008 and 0.001, respectively. The frequency of phenotypes of BChE was as follows: normal phenotype (UU) 95.5%, moderate sensitive to succinylcholine including UA,US,UF phenotypes was 3.9% and hypersensitive to succinylcholine (AA, AF, AS, FF, SS) was 0.58%.
  
  
  CONCLUSIONS
  This study indicates that the population of western Iran has a medium frequency of succinylcholine-sensitive individuals compared to other populations. We suggest that determination of BChE activity and phenotype by the micro automated method is well suited to pre-operative screening and detection of at-risk of prolonged apnea in persons receiving succinylcholine in the healthy population of western Iran.
authors.affiliation: Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Kermanshah, Iran. vaisira@yahoo.com
authors.forename: Asad
authors.initials: A
authors.lastname: Vaisi-Raygani
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Rahimi
authors.forename: Hadi
authors.initials: H
authors.lastname: Kharazi
authors.forename: Haidar
authors.initials: H
authors.lastname: Tavilani
authors.forename: Mahdi
authors.initials: M
authors.lastname: Aminiani
authors.forename: Amir
authors.initials: A
authors.lastname: Kiani
authors.forename: Aliakbar
authors.initials: A
authors.lastname: Vaisi-Raygani
authors.forename: Tayebeh
authors.initials: T
authors.lastname: Pourmotabbed
mesh_terms: D000328:Adult; D001049:Apnea / Q000139:chemically induced*; D002091:Butyrylcholinesterase / Q000097:blood / Q000235:genetics*; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D012306:Risk; D013390:Succinylcholine / Q000009:adverse effects*
chemical_list: D002091:Butyrylcholinesterase; D013390:Succinylcholine