Anesthesia Technologist Practice Exam

A dibucaine number of less than 80 suggests the avoidance of which paralytic drug?

1. Vecuronium

2. Succinylcholine

3. Cisatracurium

4. Pancuronium

The correct answer is: Succinylcholine

A dibucaine number of less than 80 indicates a deficiency in the enzyme butyrylcholinesterase, which is responsible for the metabolism of succinylcholine. Succinylcholine is a depolarizing neuromuscular blocking agent that works by mimicking the action of acetylcholine at the neuromuscular junction. It is rapidly broken down by butyrylcholinesterase, leading to its short duration of action. When there is a deficiency in butyrylcholinesterase, as suggested by a dibucaine number of less than 80, succinylcholine can lead to prolonged neuromuscular blockade because the drug will not be metabolized efficiently. This can result in extended muscle paralysis, respiratory complications, and increased risk of complications during and after surgery. Hence, an avoidance of succinylcholine in patients with a low dibucaine number is crucial for patient safety and effective management during anesthesia. On the other hand, vecuronium, cisatracurium, and pancuronium are non-depolarizing neuromuscular blockers that are not affected by butyrylcholinesterase. Their metabolism does not rely on this enzyme, making them safer alternatives in patients