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Anesthesia

What is the blood test for Pseudocholinestera

08/21/2008

Question:

My daughter`s dentist recommended sedation for a procedure she needs and I mentioned my mother has Pseudocholinesterase Deficiency. He recommended she be tested for this before the procedure. I contacted her Dr. and she said she has to have a blood test and recommended me to a genetics doctor. They were no help. Do you know what blood test she needs to have so I can ask her doctor for a script for this?

Answer:

Pseudocholinesterase deficiency is an enzyme deficiency that does not allow certain drugs, including an important anesthesia emergency drug, to be metabolized. There are alternative drugs that can be used by an anesthesiologist, but your dentist's concern is legitimate as he or she likely does not have these alternative drugs and is not trained in their use. This may not be an issue depending on the type of sedation planned.

It is also good for your daughter to know if she has inherited this deficiency (as well as her grandmother's children). If I have a patient with this condition, I simply modify my anesthetic technique slightly regardless of whether they have been tested or not.

There is a simple blood test call an Acholest test where a drop of blood is placed on a special paper and a color change occurs, detecting if a deficiency is present. I am not sure which labs in your area test for this, but you may be able to call the ones your insurance covers and find out so that your physician can order it.

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Response by:

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University