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Anesthesia

Pseudocholinesterase deficiency and Pregnancy

10/08/2007

Question:

I was diagnosed with Pseudocholinesterase Deficiency at age 10 after having a tonsilectomy and not waking from the anesthesia for 3 hours. I am now 28 years old and am pregnant with my first child. I am due in March and have been wondering about what type of pain management I will use during labor. I am very worried about having any type of anesthesia due to my condition. Is there any risk to having an epidural during labor with Pseudocholinesterase deficiency?

Answer:

Thanks for your question. Don't worry. Your risks from an epidural are no different to any other normal healthy patient's risk. You should be offered the same pain management options as anybody else.

Pseudocholinesterase deficiency is only a problem if you are given the muscle relaxant drug succinylcholine. If you needed a general anesthetic to get your baby out in a hurry this is the drug that the anesthesiologist would use. However there are alternatives, so all you need to do is make sure that your enzyme deficiency is well documented in your doctor's and hospital's records. Also, if you are planning to get an epidural, this makes the likelihood of needing a general anesthetic for a cesarean or any other obstetrical surgery rather small.

You should also consider getting and wearing a Medic-Alert bracelet with the information about your pseudocholinesterase deficiency on it.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University