Correlation of MDR1 gene polymorphism with propofol combined with remifentanil anesthesia in pediatric tonsillectomy
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YunLong Zhang1,*, Yongpei Li2,*, Hongfa Wang1, Fang Cai1, Sheliang Shen1 and Xiaopan Luo1
1Department of Anesthesiology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
2Hangzhou Women’s Hospital, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, Zhejiang, China
*The authors contributed equally to the work
Xiaopan Luo, email: [email protected]
Keywords: multidrug resistance gene; single nucleotide polymorphism; propofol; remifentanil; tonsillectomy
Received: September 07, 2017 Accepted: October 29, 2017 Epub: December 12, 2017 Published: April 17, 2018
The motive of this study was to investigate the interaction between polymorphisms in the MDR1 gene and anesthetic effects following pediatric tonsillectomy. In total, 240 children undergoing tonsillectomy with preoperative propofol-remifentanil anesthesia were selected. Genomic DNA was extracted from the peripheral blood of children after operation, and the MDR1 gene polymorphisms of 2677 G>T/A, 1236 C>T and 3435 C>T were detected by direct sequencing. We tested mean arterial pressure, diastolic blood pressure, systolic blood pressure, and heart rate at several time-points: T0 (5 mins after the repose), T1 (0â€Šmin after tracheal intubation), T2 (5 mins after the tracheal intubation), T3 (0â€Šmin after the tonsillectomy), T4 (0â€Šmin after removal of the mouth-gag) and T5 (5â€Šmin after the extubation). The visual analog scale, the face, legs, activity, cry, and consolability pain assessment, and the Ramsay sedation score were recorded after the patients regained consciousness. Adverse reactions were also recorded. The time of induction, respiration recovery, eye-opening, and extubation of children with the CC genotype were found to be shorter compared to the CTâ€Š+â€ŠTT genotype of MDR1 1236Câ€Š>â€ŠT (all Pâ€Š<.05). The mean arterial pressure, diastolic blood pressure, systolic blood pressure, and heart rate were significantly reduced at T5 in children with the CC genotype (all Pâ€Š<.05). The visual analog scale at 1, 2, 4, and 8â€Šhours post-operation, and the Ramsay sedation score at 5, 10, and 30 min after the extubation were decreased, while the face, legs, activity, cry, and consolability pain assessment score increased (all Pâ€Š<0.05). There was no statistically significant difference in the adverse reaction of MDR1 mutations (P> 0.05). It could be concluded that anesthetic effect following pediatric tonsillectomy in patients with the MDR1 1236Câ€Š>â€ŠT CC genotype was stronger than in those carrying the CTâ€Š+â€ŠTT genotype.
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