Bestas Azize, Goksu Hulya, Erhan Omer Lutfi
Department of Anesthesiology and Reanimation, Firat University School of Medicine, 23119, Elazig, Turkey,
J Clin Monit Comput. 2013 Dec;27(6):609-12. doi: 10.1007/s10877-013-9476-z. Epub 2013 May 23.
Potatoes contain solanaceous glycoalkaloids (SGAs), which inhibit both butyrylcholinesterase (BuChE) and acetylcholinesterase (AChE). The present study investigated the effect of preoperative consumption of potatoes on succinylcholine-induced block and recovery from anesthesia. ASA I-II, adult patients, scheduled for elective surgery, were included in a randomized, blind and controlled study. Patients were randomly divided into two groups. Patients in Group P (n = 21) ate a standard portion of potatoes in their last meal prior to pre-operative fasting, while patients in Group C (n = 23) ate food not containing SGAs. Patients were premedicated with midazolam. Anesthesia was induced with thiopental and fentanyl, and maintained with sevoflurane in 50 % O2/air and fentanyl, as needed. Succinylcholine 1 mg kg(-1) was administered to facilitate endotracheal intubation. Duration of succinylcholine blockade, awakening and recovery times from anesthesia were measured. Serum BuChE levels were also measured at baseline and 4 time-points within 24 h post-consumption. Duration of succinylcholine-induced neuromuscular block, awakening and recovery time from anesthesia was significantly longer in Group P than in Group C (p < 0.05). Serum BuChE levels decreased at 6 h after consumption start in Group P. In addition, in both groups, BuChE levels markedly decreased after succinylcholine blockade, increased thereafter, but did not return to baseline within 24 h of consumption start. None of these differences observed in BuChE levels was statistically significant. This study suggests that potatoes eaten before anesthesia can prolong the duration of succinylcholine-induced neuromuscular block and delay recovery from anesthesia.
土豆含有茄属糖苷生物碱(SGAs),其可抑制丁酰胆碱酯酶(BuChE)和乙酰胆碱酯酶(AChE)。本研究调查了术前食用土豆对琥珀酰胆碱诱导的阻滞及麻醉苏醒的影响。将拟行择期手术的ASA I-II级成年患者纳入一项随机、双盲对照研究。患者被随机分为两组。P组(n = 21)患者在术前禁食前的最后一餐食用标准份土豆,而C组(n = 23)患者食用不含SGAs的食物。患者均用咪达唑仑进行术前用药。用硫喷妥钠和芬太尼诱导麻醉,并根据需要用七氟醚在50%氧气/空气和芬太尼维持麻醉。给予1 mg·kg⁻¹琥珀酰胆碱以利于气管插管。测量琥珀酰胆碱阻滞持续时间、苏醒时间及麻醉恢复时间。还在食用后24小时内的基线和4个时间点测量血清BuChE水平。P组琥珀酰胆碱诱导的神经肌肉阻滞持续时间、苏醒时间及麻醉恢复时间均显著长于C组(p < 0.05)。P组食用开始后6小时血清BuChE水平下降。此外,两组中,琥珀酰胆碱阻滞后BuChE水平均显著下降,随后升高,但在食用开始后24小时内未恢复至基线水平。这些在BuChE水平上观察到的差异均无统计学意义。本研究表明,麻醉前食用土豆可延长琥珀酰胆碱诱导的神经肌肉阻滞持续时间并延迟麻醉苏醒。