Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease

Abstract Maintaining hemodynamic stability during the induction and maintenance of anesthesia is one of the challenges of the anesthesiologist. Patients with vascular disease are at increased risk of instability due to imbalance between the sympathetic and parasympathetic parts of the autonomic nerv...

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Autores principales:	Yitzhak Brzezinski-Sinai, Ester Zwang, Elena Plotnikova, Ester Halizov, Itzhak Shapira, David Zeltser, Ori Rogowski, Shlomo Berliner, Idit Matot, Shani Shenhar-Tsarfaty
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a12a7e82851f43048bf8676e07cb2bc4
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spelling	oai:doaj.org-article:a12a7e82851f43048bf8676e07cb2bc42021-12-02T15:10:46ZCholinesterase activity in serum during general anesthesia in patients with or without vascular disease10.1038/s41598-021-96251-52045-2322https://doaj.org/article/a12a7e82851f43048bf8676e07cb2bc42021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96251-5https://doaj.org/toc/2045-2322Abstract Maintaining hemodynamic stability during the induction and maintenance of anesthesia is one of the challenges of the anesthesiologist. Patients with vascular disease are at increased risk of instability due to imbalance between the sympathetic and parasympathetic parts of the autonomic nervous system, a balance accessible by serum cholinesterase activity. We aim to characterize the dynamics of cholinesterase activity in patients undergoing general anesthesia (GA) and surgery. This was a prospective study of 57 patients undergoing ambulatory or vascular surgery under GA. Cholinesterase activity was measured before the induction of anesthesia, after 15 min and at the end of surgery by calculating the capacity of serum acetylcholinesterase (AChE) and butyrylcholinesterase to hydrolyze AcetylThioCholine. Data on atherosclerotic disease, anesthesia management were analyzed. Both AChE and total cholinergic status (CS) decreased significantly after GA induction at 15 min and even more so by the end of surgery. Vascular surgery patients had lower baseline cholinesterase activity compared to ambulatory surgery patients. Patients requiring intraoperative administration of phenylephrine for hemodynamic support (21.1%) had a significantly lower level of AChE and CS compared to untreated patients. Our findings serve as a mirror to the sympathetic/parasympathetic imbalance during GA, with a marked decrease in the parasympathetic tone. The data of a subgroup analysis show a correlation between low cholinesterase activity and an increase in the need for hemodynamic support.Yitzhak Brzezinski-SinaiEster ZwangElena PlotnikovaEster HalizovItzhak ShapiraDavid ZeltserOri RogowskiShlomo BerlinerIdit MatotShani Shenhar-TsarfatyNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yitzhak Brzezinski-Sinai Ester Zwang Elena Plotnikova Ester Halizov Itzhak Shapira David Zeltser Ori Rogowski Shlomo Berliner Idit Matot Shani Shenhar-Tsarfaty Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease
description	Abstract Maintaining hemodynamic stability during the induction and maintenance of anesthesia is one of the challenges of the anesthesiologist. Patients with vascular disease are at increased risk of instability due to imbalance between the sympathetic and parasympathetic parts of the autonomic nervous system, a balance accessible by serum cholinesterase activity. We aim to characterize the dynamics of cholinesterase activity in patients undergoing general anesthesia (GA) and surgery. This was a prospective study of 57 patients undergoing ambulatory or vascular surgery under GA. Cholinesterase activity was measured before the induction of anesthesia, after 15 min and at the end of surgery by calculating the capacity of serum acetylcholinesterase (AChE) and butyrylcholinesterase to hydrolyze AcetylThioCholine. Data on atherosclerotic disease, anesthesia management were analyzed. Both AChE and total cholinergic status (CS) decreased significantly after GA induction at 15 min and even more so by the end of surgery. Vascular surgery patients had lower baseline cholinesterase activity compared to ambulatory surgery patients. Patients requiring intraoperative administration of phenylephrine for hemodynamic support (21.1%) had a significantly lower level of AChE and CS compared to untreated patients. Our findings serve as a mirror to the sympathetic/parasympathetic imbalance during GA, with a marked decrease in the parasympathetic tone. The data of a subgroup analysis show a correlation between low cholinesterase activity and an increase in the need for hemodynamic support.
format	article
author	Yitzhak Brzezinski-Sinai Ester Zwang Elena Plotnikova Ester Halizov Itzhak Shapira David Zeltser Ori Rogowski Shlomo Berliner Idit Matot Shani Shenhar-Tsarfaty
author_facet	Yitzhak Brzezinski-Sinai Ester Zwang Elena Plotnikova Ester Halizov Itzhak Shapira David Zeltser Ori Rogowski Shlomo Berliner Idit Matot Shani Shenhar-Tsarfaty
author_sort	Yitzhak Brzezinski-Sinai
title	Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease
title_short	Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease
title_full	Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease
title_fullStr	Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease
title_full_unstemmed	Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease
title_sort	cholinesterase activity in serum during general anesthesia in patients with or without vascular disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a12a7e82851f43048bf8676e07cb2bc4
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Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease

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