Pseudocholinesterase and Dibucaine Number
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Synonym/Acronym:
CHS, PCHE, AcCHS.
Rationale
To assess for pseudocholinesterase deficiency to assist in diagnosing a congenital deficiency. Special attention must be given to results for preoperative patients because positive results indicate risk for apnea with use of succinylcholine as an anesthetic drug.
Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.
Normal Findings
Method: Spectrophotometry, kinetic.
| Test | Conventional Units |
|---|---|
| Pseudocholinesterase | |
| Males | 3,334–7,031 units/L |
| Females | 2,504–6,297 units/L |
| Dibucaine Number | Fraction (%) of Activity Inhibited |
|---|---|
| Normal homozygote | 79%–84% |
| Heterozygote | 55%–70% |
| Abnormal homozygote | 16%–28% |
Critical Findings and Potential Interventions
- A positive result indicates that the patient is at risk for prolonged or unrecoverable apnea related to the inability to metabolize succinylcholine. Notify the anesthesiologist if the test result is positive and surgery is scheduled.
Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.
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Synonym/Acronym:
CHS, PCHE, AcCHS.
Rationale
To assess for pseudocholinesterase deficiency to assist in diagnosing a congenital deficiency. Special attention must be given to results for preoperative patients because positive results indicate risk for apnea with use of succinylcholine as an anesthetic drug.
Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.
Normal Findings
Method: Spectrophotometry, kinetic.
| Test | Conventional Units |
|---|---|
| Pseudocholinesterase | |
| Males | 3,334–7,031 units/L |
| Females | 2,504–6,297 units/L |
| Dibucaine Number | Fraction (%) of Activity Inhibited |
|---|---|
| Normal homozygote | 79%–84% |
| Heterozygote | 55%–70% |
| Abnormal homozygote | 16%–28% |
Critical Findings and Potential Interventions
- A positive result indicates that the patient is at risk for prolonged or unrecoverable apnea related to the inability to metabolize succinylcholine. Notify the anesthesiologist if the test result is positive and surgery is scheduled.
Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.
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