title: Pseudocholinesterase Enzyme Deficiency in Adıyaman City Area.
abstract: OBJECTIVE
  Pseudocholinesterase (PChE) is an enzyme responsible for the hydrolysis of succinylcholine. In case of its deficiency, the effect of succinylcholine that is approximately 5-10 min is prolonged up to few hours. The use of succinylcholine has been declined recently. However, it is still actively used in some special conditions and in developing countries. In this study, incidence of PChE enzyme deficiency around Adiyaman city was investigated and presented with the literature review.
  
  
  METHODS
  After obtaining an approval from the investigational board of our hospital (Adiyaman University Medical School, Biomedical Research Ethics Board, 30.12.2012, Nr: B.30.2.ADY.0.20.00-600/51), patients undergoing any elective operation under general anaesthesia in the Adiyaman University Medical School Hospital between March and December 2013 were recruited for the study. After obtaining the patients' written consents, blood PChE, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, creatinine, international normalisation ratio (INR) and activated partial thromboplastin time (aPTT) values of the patients were analysed. Possible association of the PChE deficiency with other values was also investigated. The normal value of PChE was taken as 4260-11250 for females aged 16-40 years and 5320-12920 U L(-1) for other patients.
  
  
  RESULTS
  The study was completed with 964 patients, 702 (72.8%) of whom were females. PChE enzyme levels were under the normal in 7.2% of the patients. There were no correlation between patient group, ALT, INR, aPTT and creatinine elevation with PChE deficiency (p>0.05), whereas AST and urea level elevation was significantly associated with PChE deficiency (p<0.05). The risk of PChE deficiency was 4.5 and 9 times higher in the patients with the elevation of AST and urea levels, respectively.
  
  
  CONCLUSIONS
  Pathological elevations of AST and urea that are a part of normal pre-operative biochemical analysis of blood will indicate the possible deficiency of PChE enzyme.
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Abdullayev
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Ömer Burak
authors.initials: ÖB
authors.lastname: Küçükebe
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Recai
authors.initials: R
authors.lastname: Kaya
authors.affiliation: Department of Biostatistics, Gazi University Faculty of Science, Ankara, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Çelik
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Kuşderci
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Duran
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Öznur
authors.initials: Ö
authors.lastname: Uludağ
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Öterkuş
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Aysel
authors.initials: A
authors.lastname: Buyrukcan
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Ülkü
authors.initials: Ü
authors.lastname: Sabuncu
authors.affiliation: Clinic of Biochemistry, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Arpacı
keywords: Pseudocholinesterase; butyrylcholinesterase; false cholinesterase; prolonged apnoea; serum cholinesterase