Butyrylcholinesterase deficiency and its clinical importance in anaesthesia: a systematic review.
Anaesthesia
; 74(4): 518-528, 2019 Apr.
Article
en En
| MEDLINE
| ID: mdl-30600548
ABSTRACT
Butyrylcholinesterase deficiency prolongs the effects of the drugs it degrades; succinylcholine and mivacurium. Existing literature on butyrylcholinesterase deficiency is dominated by genetic and biochemical studies. We searched MEDLINE, Embase, Web of Science and Biosis to systematically review the causes and clinical consequences of butyrylcholinesterase deficiency. We considered outcomes clinically relevant if neuromuscular blockade, induced by succinylcholine or mivacurium, was assessed using clinical criteria or neuromuscular monitoring. We included 66 studies 25 randomised controlled trials; 13 clinically controlled trials; 26 prospective observational studies; 1 retrospective study; and 1 qualitative study. Data heterogeneity precluded quantitative synthesis. Studies described genetic, physiological, acquired or pharmacologically induced causes of butyrylcholinesterase deficiency. The prolongation of neuromuscular blockade by butyrylcholinesterase deficiency was most pronounced with homozygosity of a genetic variant, but other more common factors included increasing age, pregnancy, severe liver disease, burn injuries and drug interactions.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Apnea
/
Butirilcolinesterasa
/
Anestesia
/
Errores Innatos del Metabolismo
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Qualitative_research
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Anaesthesia
Año:
2019
Tipo del documento:
Article
País de afiliación:
Dinamarca