Comparison of plasma cholinesterase levels and outcomes of Succinylcholine in pregnancy and non-pregnancy patients at Phaholpolpayuhasena Hospital

Abstract

Objective: To compare blood cholinesterase enzyme levels before and during surgery in pregnant and non-pregnant women undergoing general anesthesia and succinylcholineas a short-acting muscle relaxant for endotracheal intubation.

Methods: This analytical cross-sectional study was conducted in pregnant and non-pregnant women aged 18–45 years, ASA physical status I–III, who underwent cesarean section or other surgical procedures under general anesthesia with succinylcholine for endotracheal intubation at Phaholpolpayuhasena Hospital, Kanchanaburi Province. The study included 19 pregnant and 20 non-pregnant participants. Blood samples were collected at two time points from each participant to determine cholinesterase enzyme levels: before anesthesia induction and 10 minutes after succinylcholine administration. Data were analyzed using the independent t-test.

Results: Baseline characteristics of both groups were comparable, except for mean age, which was significantly lower in the pregnant group (p<0.001). In the pregnant group, mean blood cholinesterase levels before and during surgery were 6,968.32±1,385.07 and 5,998.47±1,343.96 units/L, respectively. In the non-pregnant group, corresponding levels were 10,078.05±2,362.41 and 8,954.50±2,431.83 units/L, respectively. Blood cholinesterase levels in pregnant women were significantly lower than those in non-pregnant women both before and during surgery (p<0.001).

Conclusion: Pregnant women exhibited significantly lower blood cholinesterase levels both before and during surgery compared with non-pregnant women. Therefore, awareness of this physiological change is essential for anesthetic management, particularly when administering succinylcholine for endotracheal intubation.