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When the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.

Testing for these enzymes is performed to identify exposure to a group of chemicals known as organophosphates (used as pesticides). These chemicals inactivate cholinesterases, and the level of these enzymes serves as an indicator of exposure and risk of toxicity.

A pseudocholinesterase level is also used, although infrequently, to identify liver disease.

This test may also be performed prior to anesthesia with succinylcholine (a paralyzing agent that is eliminated by these enzymes) to exclude a genetic deficiency of these enzymes. This is often done in individuals who have a family history of a prolonged drug effect during anesthesia.

Succinylcholine is one agent used before electroconvulsive therapy (ECT) to prevent a full-blown seizure during treatment. Your health care provider can determine your potential response to succinylcholine with this test.

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Normal Values

The normal value of acetylcholinesterase and pseudocholinesterase depends on the technique, and should be determined by the laboratory performing the test. Typically, normal pseudocholinesterase values range between 8 and 18 U/ml.

Note: U/ml = units per milliliter

What abnormal results mean

Decreased pseudocholinesterase levels may be seen in:

Congenital deficiency Poisoning with organophosphates Liver damage Acute infection Chronic malnutrition Metastasis Myocardial infarction (heart attack) Obstructive jaundice Smaller decreases are seen during:

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Pregnancy Use of oral contraceptives What the risks are

Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken) Multiple punctures to locate veins

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This test measures the amount of ketones in the blood. Any amount of detectable ketones is considered abnormal.