Name of the Procedure:

Dibucaine Number Test
(Commonly known as Pseudocholinesterase Inhibition Test)

Summary

The Dibucaine Number Test is a blood test designed to evaluate the activity of an enzyme called pseudocholinesterase. This test helps determine how well the enzyme breaks down certain muscle relaxant drugs used during anesthesia.

Purpose

The test addresses conditions related to abnormal pseudocholinesterase activity, which can lead to prolonged muscle paralysis after anesthesia. The goal is to identify whether a patient has a genetic variation that affects the breakdown of certain muscle relaxants.

Indications

• Patients who have experienced prolonged paralysis after receiving muscle relaxants such as succinylcholine.
• Family history of abnormal pseudocholinesterase activity.
• Pre-operative evaluation for patients with suspected enzyme deficiency.

Preparation

• No special preparation is usually required.
• Inform the healthcare provider of any medications being taken, as some drugs can affect enzyme activity.
• Fasting may not be necessary unless other blood tests are scheduled.

Procedure Description

1. A small blood sample is drawn from the patient, typically from a vein in the arm.
2. The sample is sent to a laboratory where it is exposed to dibucaine, a local anesthetic.
3. The test measures how much the enzyme activity is inhibited by dibucaine.
4. The results are reported as a number, called the Dibucaine Number.

Duration

The actual blood draw takes about 5-10 minutes. Laboratory analysis can take several hours to a few days, depending on the facility.

Setting

The blood sample is usually taken in a hospital, outpatient clinic, or laboratory.

Personnel

• Phlebotomist or nurse for blood draw.
• Laboratory technician or pathologist for analysis.

Risks and Complications

• Minor risks include discomfort, bruising, or infection at the needle site.
• Rarely, patients may experience dizziness or fainting during the blood draw.

Benefits

• Identifies patients at risk for prolonged paralysis from specific muscle relaxants.
• Helps in tailoring anesthesia plans to prevent complications.
• Provides valuable genetic information that could be useful for family members.

Recovery

• Minimal recovery is needed.
• Patients can usually resume normal activities immediately after the blood draw.
• Follow-up may be required to discuss test results and implications.

Alternatives

• Genetic testing for enzyme deficiency.
• Clinical assessment during previous surgeries (if available experiences are there).
• Use of alternative muscle relaxants that do not rely on pseudocholinesterase for breakdown.

Patient Experience

• Mild discomfort during the blood draw.
• No significant pain or complications are expected.
• Results and next steps are typically discussed in a follow-up appointment.

This markdown provides a comprehensive yet concise overview of the Dibucaine Number Test, covering all essential aspects from name and purpose to patient experience and alternatives.