Leighton B L, Cheek T G, Gross J B, Apfelbaum J L, Shantz B B, Gutsche B B, Rosenberg H
Anesthesiology. 1986 Feb;64(2):202-5. doi: 10.1097/00000542-198602000-00012.
Serum cholinesterase activity decreases 30% during pregnancy and remains depressed during the postpartum period. However, succinylcholine recovery is not prolonged in term-pregnant patients. This contrasts with results obtained in other patients with decreased serum cholinesterase activity. To better understand this paradox, the authors compared serum cholinesterase activity and recovery from succinylcholine, 1 mg/kg, in nonpregnant (with and without oral contraceptive use), in term-pregnant, and in postpartum patients. Serum cholinesterase activity was lower in both term-pregnant (3.66 +/- 0.39 U/ml, means +/- SE) and postpartum (2.84 +/- 0.35 U/ml) patients than in nonpregnant patients not taking oral contraceptives (5.01 +/- 0.33 U/ml, P less than 0.05). Cholinesterase activity in postpartum patients also was significantly lower than in nonpregnant patients taking oral contraceptives (4.81 +/- 0.63, P less than 0.05). In contrast, the time to 25% twitch-height recovery did not differ between term-pregnant (470 +/- 56 s) and nonpregnant patients taking (499 +/- 29 s) or not taking (501 +/- 21 s) oral contraceptives, but was significantly increased in postpartum patients (685 +/- 22 s, P less than 0.001). The similar duration of action of succinylcholine in term-pregnant patients (with decreased serum cholinesterase activities) and nonpregnant patients may be related to the increased volume of distribution of succinylcholine at term.
孕期血清胆碱酯酶活性下降30%，产后仍处于低水平。然而，足月妊娠患者琥珀酰胆碱的恢复时间并未延长。这与其他血清胆碱酯酶活性降低的患者的结果形成对比。为了更好地理解这一矛盾现象，作者比较了非妊娠（使用和未使用口服避孕药）、足月妊娠和产后患者的血清胆碱酯酶活性以及静脉注射1mg/kg琥珀酰胆碱后的恢复情况。足月妊娠患者（3.66±0.39U/ml，均值±标准误）和产后患者（2.84±0.35U/ml）的血清胆碱酯酶活性均低于未服用口服避孕药的非妊娠患者（5.01±0.33U/ml，P<0.05）。产后患者的胆碱酯酶活性也显著低于服用口服避孕药的非妊娠患者（4.81±0.63，P<0.05）。相比之下，足月妊娠患者（470±56秒）与服用（499±29秒）或未服用（501±21秒）口服避孕药的非妊娠患者达到25%颤搐高度恢复的时间并无差异，但产后患者的时间显著延长（685±22秒，P<0.001）。足月妊娠患者（血清胆碱酯酶活性降低）与非妊娠患者琥珀酰胆碱作用持续时间相似，可能与足月时琥珀酰胆碱分布容积增加有关。
