Weight, Pseudocholinesterase Activity, and Succinylcholine Requirement

Bentley, John B.; Borel, J. D.; Vaughan, R. W.; Gandolfi, A. Jay

doi:10.1097/00132586-198306000-00019

Cited by 14 publications

(20 citation statements)

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“…Succinylcholine is a depolarizing muscle relaxant whose duration of action is primarily determined by the level of pseudocholinesterase activity in the blood and the volume of extracellular fluid space. Bentley et al [96] reported that increasing weight is associated with increased pseudocholinesterase activity, which could be related to the increased metabolic activity that occurs in obesity. They advised that in adult obese patients succinylcholine be administered on the basis of total rather than lean body weight.…”

Section: Muscle Relaxantsmentioning

confidence: 99%

Anesthesia in the obese patient: Pharmacokinetic considerations

Casati

Putzu

2005

Journal of Clinical Anesthesia

191

128

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Section: Muscle Relaxantsmentioning

confidence: 99%

Anesthesia in the obese patient: Pharmacokinetic considerations

Casati

Putzu

2005

Journal of Clinical Anesthesia

191

128

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“…The activity of pseudocholinesterase-the enzyme that metabolizes succinylcholine-increases linearly with BMI. 10 Pharmacogenetic variants can have a significant effect on the elimination clearance of opioids. However, in the perioperative period, distribution and redistribution processes contribute to plasma and effect-site concentration decrements as much asand maybe even more than-elimination clearance alone.…”

Section: Perspec Tivesmentioning

confidence: 99%

Individualized Dosing With Anesthetic Agents

Lemmens

Stanski

2012

Clin Pharmacol Ther

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The development of fundamental pharmacokinetics and pharmacodynamics concepts has enabled anesthesiologists to choose and dose anesthetic agents on a rational basis. The application of these concepts to a variety of clinical scenarios and patient populations makes it possible to individualize the dose, thereby decreasing the risk of complications. As more knowledge is gained about the sometimes profound differences in drug response, empirical dosing such as in milligrams per kilogram of total body weight is disappearing from the anesthesia specialty.

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“…In morbidly obese patients the concentration of pseudocholinesterase, the enzyme that metabolizes succinylcholine, is increased [47]. When succinylcholine is administered on the basis of TBW a more profound neuromuscular block and better incubating conditions are achieved compared with when given by LBW or IBW [48].…”

Section: Muscle Relaxantsmentioning

confidence: 99%

Anesthetic drugs and bariatric surgery

Lemmens¹,

Brodsky²

2006

Expert Review of Neurotherapeutics

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The prevalence of obesity is increasing worldwide. For severely obese patients, bariatric surgery is the only effective option for sustained weight loss and associated health improvement. As a consequence, the number of bariatric surgical procedures being performed is growing exponentially. Systematic knowledge regarding the effect of obesity on the pharmacokinetics and pharmacodynamics of anesthetic agents is generally lacking, and data for morbidly obese (body mass index [BMI] 40-49 kg/m2)) and super-obese patients (BMI > 50 kg/m2) are almost completely non-existent. Most drug-dosing guidelines are based on results from relatively small studies in moderately obese patients. Future systematic pharmacological research is needed for improved and more rational peri-operative care of morbidly obese patients.

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Weight, Pseudocholinesterase Activity, and Succinylcholine Requirement

Cited by 14 publications

References 0 publications

Anesthesia in the obese patient: Pharmacokinetic considerations

Anesthesia in the obese patient: Pharmacokinetic considerations

Individualized Dosing With Anesthetic Agents

Anesthetic drugs and bariatric surgery

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