Choline Esterase II
Evaluate preoperative patients for succinylcholine (suxamethonium) anesthetic sensitivity, genetic or secondary to insecticide exposure, in appropriate circumstances. To prevent or evaluate prolonged anesthetic effect, prolonged apnea, after surgery. Very small amounts (0.04−0.06 mg/kg) of succinylcholine are needed to obtain 90% of neuromuscular blockade in patients with low levels of plasma cholinesterase activity.1
Two types of cholinesterase are found in blood: “true” cholinesterase (acetylcholinesterase) in red cells and “pseudocholinesterase” (acylcholine acylhydrolase) in serum (plasma). Low plasma or serum cholinesterase activity may relate to exposure to insecticides or to one of a number of variant genotypes. Dibucaine and fluoride numbers are useful to phenotype such homozygous and heterozygous individuals, who are genetically sensitive to succinylcholine.
Lavender-top (EDTA) tube
Separate plasma from cells immediately and place in transport tube. Mark transport tube “plasma.” Use of other anticoagulants is not recommended.
Maintain specimen at room temperature.
Room temperature 14 days
Refrigerated 14 days
Frozen 14 days
Freeze/thaw cycles Stable x3
Whole blood specimen (a 20% to 25% increase can occur during a 24-hour period if plasma is left in contact with the red cells); anticoagulants other than EDTA; hemolysis
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