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 Field Name  Data Description
Test Name  Dibucaine, S/RBC Cholines
Code  Dibucaine, S/RBC Cholines.
CPT Code  82482,82480,82638
Last Modified  3/23/2018 11:00:00 AM
Test Name  DBC S/RBC.
Synonyms  Cholinesterase Inhibition by Dibucaine, Pseudocholinesterase Inhibition, Dibucaine number with serum and RBC cholinesterase
Patient Preparation  Do NOT collect within 24 hours of administration of muscle relaxant
Spec. Requirements  Whole Blood
Tube  Red or Gold AND Lavender(EDTA)
Collection Volume  4.0 mL Red, 3.5 mL Gold and 2.0 mL Lavender
Storage  Ambient or Refrigerate 14 days
Routine TAT  
Days Test Performed  
Performed by BHS  None
See Availability  
Reference Lab  LabCorp of America
Reference Lab Code  121152 Dibucaine, S/RBC Cholines
Clinical Use  Assess the presence of homozygous or heterozygous "atypical" cholinesterase variant, in patients who have low result of serum or plasma cholinesterase assay, and may be at risk of apnea when given succinylcholine muscle relaxant. The degree of serum or plasma cholinesterase inhibition produced by dibucaine is under genetic control. Sensitivity to succinyl choline is dependent upon at least four allelic genes. The total quantitative cholinesterase determination may not be reliable in detecting sensitivity to succinyl choline as variant enzymes exhibit qualitative and quantitative differences in substrate specificity. The dibucaine number indicates the percent inhibition of enzyme activity by this agent when a serum or plasma sample is tested under standard conditions (inhibition expressed as a percent). This approach to detection of serum or plasma cholinesterase variants does not entirely avoid the problem of variation in reactivity with some atypical enzymes. Prolonged apnea following hemodilutional cardiopulmonary bypass has been reported in a patient whose admission (preoperative) plasma cholinesterase level was slightly below the normal range.
Reference Range  
Critical Value  
Testing Sample Type  Serum AND Whole blood
Min Lab Testing Volume  0.5 mL serum AND 1.0 mL whole blood
Special Handling  Collection:Separate serum from cells in red-top tube and place in transport tube marked "serum". Do NOT separate EDTA tube.
Lab Notes  Stability:Room temperature. Whole blood (RBC): Stable at room temperature or refrigerated for 14 days and unstable frozen. Serum: Stable at room temperature, refrigerated, or frozen for 14 days; freeze/thaw cycles: stable x3.
Methodology  S - Spectrophotometry
Limitations  No single simple test currently exists that can detect all enzyme variants. Causes of Rejection:Serum not separated from cells; serum AND whole blood specimens not sent; anticoagulants other than EDTA (RBC only); frozen whole blood received; hemolyzed serum

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