Dibucaine hydrochloride is an amide-type local anesthetic and it is well known to be a contact allergen. Although there are some reports of allergic contact dermatitis due to over-the-counter medications containing dibucaine in the foreign literature, there is only one report of it in the Korean literature. We report here on a case of allergic contact dermatitis due to an over-the-counter drug containing dibucaine in a 41-year-old-woman. The patch test with the preparation that she had used and the TRUE(R) test revealed positive reactions to the dibucaine mix and Moscool(R).
Dermatitis, Allergic Contact ; Dibucaine ; Patch Tests

Pseudocholinesterase is an essential enzyme for hydrolysis of succinylcholine and some people has low activity. The pseudocholinesterase from a normal individual has a greater apparent affinity for the cholinester substrate than the enzyme from succinylcholine-sensitive individuals, who has genetic variants. The ideal situation would be one in which a single, simple test would detect and identify all the variant forms of enzyme, but no such test currently exsits. The inhibitors frequently used to identify variants are dibucaine, fluoride, chloride, urea or succinylcholine as inhibition numbers. The authors found that dibucaine, fluoride and chloride numbers in Korean adults (mean+/-SD, %) are 85.8+/-1.83, 46.5+/-2,05 and 3.53+/-1.64, respectively (substrate is butyrylthiocholine).
Adult* ; Dibucaine ; Fluorides ; Humans ; Hydrolysis ; Pseudocholinesterase* ; Succinylcholine ; Urea

Frequency-force relationships (FFR) were studied in electrically field stimulated rat left atria (LA) by reducing the stimulation frequency from resting 3 Hz to test frequencies (0.1-1 Hz) for 5 minutes. The twitch amplitudes of LA elicited the typical negative staircases with 3-phased changes: the initial rapid increase, the second decrease and the following plateau at test frequencies. Verapamil (3 X 10-5 M) pretreatment elicited frequency-dependent suppression of the twitch amplitudes, exaggerating the negative staircase. Monensin pretreatment enhanced not the peak but the plateau amplitudes in a concentration-dependent manner. When the Na+-Ca2+ exchange was blocked by Na+ and Ca2+ depletion in the Krebs Hensleit buffer (0 Na+-0 Ca2+ KHB), the twitch amplitudes increased in a frequency-dependent manner, changing the negtive staircase into the positve one. Meanwhile, the 0 Na+-0 Ca2+ KHB applicationinduced enhancement was strongly suppressed by caffeine (5 mM) pretreatment. Only dibucaine among the local anesthetics increased the basal tone during frequency reduciton. There were no differences in 45Ca uptakes between 0.3 Hz and 3 Hz stimulation except at 1 min when it was significantly low at 0.3 Hz than 3 Hz, illustrating net Ca2+ losses. Monensin pretreatment enhanced the rate of this Ca2+ loss. Taken together, it is concluded that Na+-Ca2+ exchange extrudes more SR released Ca2+ out of the cell in proportion to the frequency, resulting in the negative rate staircase in the rat LA.
Anesthetics, Local ; Animals ; Caffeine ; Dibucaine ; Monensin ; Rats ; Verapamil

T-can is one of the most widely available local anesthetics for spinal anesthesia in Korea and we use T-cain almost exclusively. However, some anesthetists prefer other local anesthetics such as dibucaine, bupivacaine, or lidocaine for spinal anesthesia. We examined the hemodynamic effects, onset, spread, and duration of sensory and motor blockade following spinal anesthesia with 0.5% T-cain, 0.24% dibucaine, and 0.3% dibucaine. The results were as follows: 1) The blood pressure and pulse rate were decreased by all three drugs without significant difference among the three drugs. 2) The onset of sensory blockade was faster with T-cain than with dibucaine. T-cain containing 0.24% dibucaine had faster onset than the 0.3% solution. The spread of analgesia was also more rapid with T-cain than with dibucaine. 3) The motor blockade was significantly faster and more profound with T-cain than with dibucaine. 4) The duration of anesthesia was the shortest with T-cain containing 0.24% dibucaine and the longest with 0.3% dibucaine, but there was no statistical significance. From the above results, T-cain proved to be a more profound and shorter lasting local anesthetic than dibucaine. However, sensory and motor blockade produced by dibucaine were clinically acceptable. Therefore, both T-cain and dibucaine can be clinically available for spinal anesthesia.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Blood Pressure ; Bupivacaine ; Dibucaine* ; Heart Rate ; Hemodynamics ; Korea ; Lidocaine

The authors experienced a case of plasma cholinesterase variant who received succinylcholine, atracurium and reversal with pyridostigmine, and showed prolonged neuromuscular blockade postoperatively, and was ventilated artificia1ly until complete recovery. The patient and her two children later gave samples of blood. The patients blood revealed very low plasma cholinesterase activity of 0.11 IU/L(normal range; 5-12 IU/L) and dibucaine number of 33. In consideration of her childrens plasma cholinesterase activities and dibucaine numbers, we suggest that she has genetically abnormal plasma cholinesterase and probably her genotype is E E or E E.
Atracurium ; Child ; Cholinesterases ; Dibucaine ; Genotype ; Humans ; Neuromuscular Blockade* ; Plasma* ; Pyridostigmine Bromide ; Succinylcholine

BACKGROUND: It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine hydrochloride help patients with such cancer pain. This study evaluated the efficacy of trigger point injections for alleviating pain in patients with advanced cancer. METHODS: Twenty patients with advanced cancer who had a life expectancy of 6 months or less and had been diagnosed with myofascial pain syndrome were treated with trigger point injections. Prior to treatment, a Visual Analog Scale (VAS) was used to measure the resting pain level and discomfort upon application of pressure on the site of pain. These values were compared with last treatment measurements. RESULTS: The mean pre-treatment VAS scores for pain at rest and upon application of pressure on the pain site were 7.3 and 9.0, respectively. These scores decreased significantly to 1.95 and 3.2, respectively, after the treatment (P<0.05). CONCLUSION: Trigger point injection is an alternative and effective pain control modality for advanced cancer patients with myofascial pain syndrome.
Dibucaine ; Humans ; Life Expectancy ; Myofascial Pain Syndromes ; Trigger Points ; Visual Analog Scale

The present study was designed to assess the roles of PLA2 activation and arachidonic acid (AA) metabolites in hypoxia-induced renal cell injury. Hypoxia increased LDH release in a dose-dependent manner in rabbit renal cortical slices, and this increase was significant after 20-min hypoxia. The hypoxia-induced LDH release was prevented by amino acids, glycine and alanine, and extracellular acidosis (pH 6.0). Buffering intracellular Ca2+ by a chelator, but not omission of Ca2+ in the medium produced a significant reduction in hypoxia-induced LDH release. The effect of hypoxia was blocked by PLA2 inhibitors, mepacrine, butacaine, and dibucaine. A similar effect was observed by a 85-kD cPLA2 inhibitor AACOCF3. AA increased hypoxia-induced LDH release, and albumin, a fatty acid absorbent, prevented the LDH release, suggesting that free fatty acids are involved in hypoxia-induced cell injury. These results suggest that PLA2 activation and its metabolic products play important roles in pathogenesis of hypoxia-induced cell injury in rabbit renal cortical slices.
Acidosis ; Alanine ; Amino Acids ; Anoxia ; Arachidonic Acid ; Dibucaine ; Fatty Acids, Nonesterified ; Glycine ; Phospholipases A2* ; Phospholipases* ; Quinacrine

BACKGROUND: Many reports on the change of pseudocholinesterase activity in pregnant women showed that it declines during pregnancy and in the immediate postpartum period. In Korea, there are two papers that show dissident results. However, they didn't prove that the subjects in their studies had genotypically normal enzyme. So, we compared the pseudocholinesterase activities between nonpregnant and term-pregnant women who have the genotypically normal enzyme. METHODS: We measured the dibucaine, fluoride, chloride number as well as the pseudocholinesterase astivity using butyrylthiocholine as substrate by automatic analyser, urea and scoline numbers using benzoylcholine as substrate by manual technique in nonpregnant(n=15) and term-pregnant(n=15) women aging 20 to 40 years old before induction of anesthesia. RESULTS: The dibucaine, fluoride, chloride, urea and scoline numbers(mean+/-SD,%) in female subjects were 86+/-1.2, 50+/-5.2, 5+/-2.4, 47+/-2.8 and 92+/-2.0, respectively. There were two subjects showing low pseudocholinesterase activity(<4.8 U/ml) and the one(3.9 U/ml) was in nonpregnant group, the other(4.5 U/ml) in term-pregnant group. We found that they had genotypically normal enzymes because their inhibition numbers were within normal ranges. Pseudocholinesterase activity(mean+/-SD) in term-pregnant group(7.04+/-1.30) was significantly decreased compared with that in nonpregnant group(9.15+/-2.01)(P<0.01). CONCLUSIONS: We conclude that in subjects with the genotypically normal enzyme, term-pregnant women had significantly lower pseudocholinesterase activity than nonpregnant ones did.
Adult ; Aging ; Anesthesia ; Benzoylcholine ; Butyrylthiocholine ; Dibucaine ; Female ; Fluorides ; Humans ; Korea ; Postpartum Period ; Pregnancy ; Pregnant Women ; Pseudocholinesterase* ; Reference Values ; Urea

OBJECTIVETo study the effect of reactive oxygen species (ROS) on the regulation of platelet apoptosis.

METHODSWashed healthy human platelets were pre-incubated with N-caetyl-Lcysteine (NAC), and then stimulated with dibucaine or thrombin. The production of ROS and depolarization of mitochondrial membrane potential (∆ ψm) were detected by flow cytometry. The activation of caspase-3 and expression of Bcl-xL were analyzed by Western blot.

RESULTS(1)The average ROS fluorescence value of NAC+dibucaine group was lower than that of dibucaine group(0.66 ± 0.11 vs 1.06 ± 0.08, P<0.01), while that of NAC+thrombin group was also lower than that of thrombin group(0.45 ± 0.05 vs 0.71 ± 0.11, P=0.001). (2)The percentage of platelets with normal ∆ψm in NAC+Dibucaine group was higher than that of dibucaine group[(86.30 ± 9.37)% vs (13.52 ± 3.01)%, P=0.000], while that of NAC+thrombin group was also higher than that of thrombin group[(93.00 ± 3.03)% vs (76.58 ± 5.28)%, P=0.000]. (3)Fragmentation generated by caspase-3 activation in dibucaine group was much more than that in DMSO control group, while the fragmentation in NAC+dibucaine group was significantly decreased. (4)The expression of anti-apoptosis protein Bcl-xL of NAC+dibucaine group was significantly higher than that of the dibucaine group, while that of NAC+thrombin group was also higher than that of thrombin group.

CONCLUSIONThrough the regulation of ROS, NAC could inhibit the platelet apoptosis induced by dibucaine or thrombin.

Acetylcysteine ; pharmacology ; Apoptosis ; drug effects ; physiology ; Blood Platelets ; drug effects ; metabolism ; physiology ; Caspase 3 ; metabolism ; Dibucaine ; pharmacology ; Humans ; Membrane Potential, Mitochondrial ; physiology ; Reactive Oxygen Species ; metabolism ; Thrombin ; pharmacology ; bcl-X Protein ; metabolism