Break the Spasm with Succinylcholine, but Risk Intraoperative Awareness with Undiagnosed Pseudocholinesterase Deficiency

Table 1

Results of the patient’s serum cholinesterase level and the percent inhibition by dibucaine.

	Reference range	Patient result
Cholinesterase, plasma	2673–6592 IU/L	608 (L)
Dibucaine inhibition	81.6–88.3% inhibition	34.8 (L)

Dibucaine inhibition is the percent of the pseudocholinesterase enzyme inhibited by the local anesthetic dibucaine. A dibucaine number less than 30 in addition to decreased plasma cholinesterase activity indicates a patient at high risk for prolonged paralysis after succinylcholine use [1].