It might sound bizarre, but anesthetists in hospitals in Coimbatore solicit caste details of patients before administering anesthesia. The precaution is taken because the patients belonging to the Arya Vaisya Chettiar clan, popularly known as Kommutti Chettiars, are believed to be fatally allergic to some anesthetics. Arya Vaisya Chettiar, one of the 24 sects of the Chettiar community, are extremely allergic to the muscle relaxant or the paralyzing anesthetic agent, Suxamethonium popularly known as Scoline, say anesthetics here.
“The enzyme, pseudo choline esterase, present in the human body, helps patients regain consciousness after administration of anesthesia. This may be completely absent or present in reduced concentration in blood of people belonging to this particular community. An atypical form of this enzyme is also sometimes present in such patients and so they are unable to regain consciousness within the stipulated time,” says Dr. B.S. Dhanashekaran, an anesthesiologist in the city. Sometimes, the patient does not awaken even after five to six hours afterwards when Scoline is administered and in certain cases they die, he says.
“The genetic predisposition of the community does not permit intake of this drug,” he explains. It has been found that some Aryan sub-sects in various parts of the world are also similarly allergic, says Dr.Balavenkatasubramainan, a city-based anesthesiologist who belongs to the same community. As the reaction visible is same in the case of Aryans and the Arya Vaisya Chettiar clan, several Indian researchers believe that there is a clear link between the two.
“This seems to be more of a racial defect and both the mother and father can pass on this defect to the progeny,” says anesthesiologist. The CAS Guidelines to the practice of Anesthesia say that for others who are not allergic to it. Suxamethonium produces rapid, complete, and predictable paralysis and recovery is spontaneous. It is administered in severe liver disease and patients with burn injuries.
Please spread this message far and wide & inform all your Chettiar friends to inform their anesthetists about this enzyme deficiency before any surgery.
