title: How important is the butyrylcholinesterase level for cesarean section?
abstract: OBJECTIVE
  Butyrylcholinesterase (BChE), commonly known as pseudocholinesterase or non-neural cholinesterase, hydrolyzes neuromuscular blocker agents containing choline esters such as succinylcholine that is widely used in rapid sequence induction (RSI) for general anesthesia. The aim of this study is to compare plasma BChE levels and investigate the affects and relationship of succinylcholine on BChE levels in preeclamptic, gestational diabetic and healthy pregnants.
  
  
  METHODS
  We designed a prospective, controlled, pilot single-center study. Thirty (n=30) pregnant women who were scheduled for cesarean section under general anesthesia (refusal of regional anesthesia) with RSI involved. Group 1 included ten (n=10) preeclamptic pregnancies, Group 2 included ten (n=10) gestational diabetic (GD) pregnancies and Group 3 included ten (n=10) healthy pregnancies.
  
  
  METHODS
  BChE levels of all patients were measured prior to the initiation of cesarean section. Train-of-four recovery of 90% (TOF T1) was used to monitor the degree of neuromuscular block beginning from the administration of succinylcholine.
  
  
  RESULTS
  No statistically significant difference was found between the groups comparing BChE levels and the duration between tracheal intubation and formation of TOF T1 (p>0.05).
  
  
  CONCLUSIONS
  As similar results were gathered from normal and high-risk pregnancies (preeclamptic pregnancy or gestational diabetic pregnancy) who underwent cesarean section under general anesthesia, we believe that succinylcholine is still neuromuscular agent of choice in cesarean section.
authors.affiliation: Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Anesthesiology, Istanbul, Turkey. Electronic address: ginangil@gata.edu.tr.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Inangil
authors.affiliation: Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Anesthesiology, Istanbul, Turkey. Electronic address: sdeniz.md@gmail.com.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Deniz
authors.affiliation: Gulhane Military Medical Academy, Department of Biochemistry, Ankara, Turkey. Electronic address: ygkurt@gata.edu.tr.
authors.forename: Yasemin Gulcan
authors.initials: YG
authors.lastname: Kurt
authors.affiliation: Gulhane Military Medical Academy, Department of Obstetrics & Gynecology, Ankara, Turkey. Electronic address: drugurkeskin@gmail.com.
authors.forename: Ugur
authors.initials: U
authors.lastname: Keskin
authors.affiliation: Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Anesthesiology, Istanbul, Turkey. Electronic address: omerbakal@yahoo.com.
authors.forename: Omer
authors.initials: O
authors.lastname: Bakal
authors.affiliation: Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Anesthesiology, Istanbul, Turkey. Electronic address: drhuseyinsen@gmail.com.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Sen
authors.affiliation: Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Anesthesiology, Istanbul, Turkey. Electronic address: sezaiozkan1@yahoo.com.
authors.forename: Sezai
authors.initials: S
authors.lastname: Ozkan
authors.affiliation: Gulhane Military Medical Academy, Department of Anesthesiology, Ankara, Turkey. Electronic address: ekurt@gata.edu.tr.
authors.forename: Ercan
authors.initials: E
authors.lastname: Kurt
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D015415:Biomarkers / Q000097:blood; D002091:Butyrylcholinesterase / Q000097:blood*; D002585:Cesarean Section; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000601:surgery*; D005260:Female; D006801:Humans; D006868:Hydrolysis; D007442:Intubation, Intratracheal; D009467:Neuromuscular Depolarizing Agents / Q000378:metabolism / Q000627:therapeutic use*; D061886:Neuromuscular Monitoring; D010865:Pilot Projects; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000601:surgery*; D011247:Pregnancy; D011446:Prospective Studies; D013390:Succinylcholine / Q000378:metabolism / Q000627:therapeutic use*; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
chemical_list: D015415:Biomarkers; D009467:Neuromuscular Depolarizing Agents; D002091:Butyrylcholinesterase; D013390:Succinylcholine
keywords: Butyrylcholinesterase; Cesarean section; Succinylcholine