Chloroprocaine and Pseudocholinesterase Deficiency

Abstract

To the Editor.— The recent article by Freeman and Arnold (231:56,1975) suggests that chloroprocaine may be safer for paracervical block because it is rapidly degraded by fetal plasma cholinesterase. A potential hazard arises in the case of an infant with inherited pseudocholinesterase deficiency. Since this condition is inherited as an autosomal recessive trait, the parents might not have shown previous sensitivity to local anesthetics or succinylcholine but will have impaired ability to degrade these drugs. Therefore, the dose to the fetus will be increased because of sustained high levels in the mother's circulation. Although rare, this disorder should be kept in mind by physicians using these drugs.