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Ding Y, Liu A, Wang Y, Zhao S, Huang S, Zhu H, Ma L, Han L, Shu S, Zheng L, Chen X. Genetic polymorphisms are associated with individual susceptibility to dexmedetomidine. Front Genet 2023; 14:1187415. [PMID: 37693312 PMCID: PMC10483403 DOI: 10.3389/fgene.2023.1187415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction: Dexmedetomidine (DXM) is widely used as an adjuvant to anesthesia or a sedative medicine, and differences in individual sensitivity to the drug exist. This study aimed to investigate the effect of genetic polymorphisms on these differences. Methods: A total of 112 patients undergoing hand surgery were recruited. DXM 0.5 μg/kg was administered within 10 min and then continuously injected (0.4 μg/kg/h). Narcotrend index, effective dose and onset time of sedation, MAP, and HR were measured. Forty-five single nucleotide polymorphisms (SNPs) were selected for genotype. Results: We observed individual differences in the sedation and hemodynamics induced by DXM. ABCG2 rs2231142, CYP2D6 rs16947, WBP2NL rs5758550, KATP rs141294036, KCNMB1 rs11739136, KCNMA1 rs16934182, ABCC9 rs11046209, ADRA2A rs1800544, and ADRB2 rs1042713 were shown to cause statistically significant (p < 0.05) influence on the individual variation of DXM on sedation and hemodynamics. Moreover, the multiple linear regression analysis indicated sex, BMI, and ADRA2A rs1800544 are statistically related to the effective dose of DXM sedation. Discussion: The evidence suggests that the nine SNPs involved in transport proteins, metabolic enzymes, and target proteins of DXM could explain the individual variability in the sedative and hemodynamic effects of DXM. Therefore, with SNP genotyping, these results could guide personalized medication and promote clinical and surgical management.
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Affiliation(s)
- Yuanyuan Ding
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Aiqing Liu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yafeng Wang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuai Zhao
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiqian Huang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongyu Zhu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lulin Ma
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linlin Han
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaofang Shu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lidong Zheng
- Department of Anesthesiology, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an, China
| | - Xiangdong Chen
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhang Q, Zhen J, Hui Z, Meng X, Guan J, Zhang H, Zhang J. Effect of dexmedetomidine on oxytocin-induced uterine contraction during optimal caesarean section anaesthesia. Basic Clin Pharmacol Toxicol 2022; 131:53-59. [PMID: 35524415 DOI: 10.1111/bcpt.13740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 12/25/2022]
Abstract
Numerous drugs are used during caesarean sections to provide regional and general anaesthesia. Dexmedetomidine has been used in some recent obstetric trials, but there are concerns about postpartum changes in uterine contractions. This study evaluated the effect of dexmedetomidine on oxytocin-induced uterine contractions in women undergoing caesarean section. Sixty women undergoing caesarean section in Lianyungang Second People's Hospital were randomly assigned to dexmedetomidine (group D, n = 30) or saline (group C, n = 30) groups. Equal volumes of saline or dexmedetomidine were administered intravenously (IV). During the intraoperative delivery of the foetus and placenta, oxytocin was administered to promote contractions. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were compared. The Ramsay scale was used to assess sedation, while the Tsai and Chu methods assessed shivering. Adverse intraoperative events were observed. All variables fluctuated significantly after anaesthesia onset in both groups but were most pronounced in group D. The VAS, Ramsay and shivering scores were significantly lower in group D compared to group C. During rapid IV infusion of oxytocin after foetal delivery, the incidence of nausea, vomiting, chest tightness and hypotension was significantly lower in group D than in group C.
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Affiliation(s)
- Quanyun Zhang
- Department of Pain Medical Center, Lianyungang Second People's Hospital, Lianyungang, Jiangsu, China
| | - Jin Zhen
- Department of Anesthesiology, Lianyungang Second People's Hospital, Lianyungang, Jiangsu, China
| | - Zhang Hui
- Department of Anesthesiology, Lianyungang Second People's Hospital, Lianyungang, Jiangsu, China
| | - Xiangxue Meng
- Department of Anesthesiology, Lianyungang Second People's Hospital, Lianyungang, Jiangsu, China
| | - Jinping Guan
- Department of Anesthesiology, Lianyungang Second People's Hospital, Lianyungang, Jiangsu, China
| | - Hongjin Zhang
- Department of Pain Medical Center, Lianyungang Second People's Hospital, Lianyungang, Jiangsu, China
| | - Junlong Zhang
- Department of Anesthesiology, Lianyungang Second People's Hospital, Lianyungang, Jiangsu, China
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Gallaway KA, Skaar TC, Biju A, Slaven J, Tillman EM. A pilot study of ADRA2A genotype association with doses of dexmedetomidine for sedation in pediatric patients. Pharmacotherapy 2022; 42:453-459. [PMID: 35429176 PMCID: PMC9325491 DOI: 10.1002/phar.2684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/09/2023]
Abstract
STUDY OBJECTIVE Dexmedetomidine is titrated to achieve sedation in the pediatric and cardiovascular intensive care units (PICU and CVICU). In adults, dexmedetomidine response has been associated with an ADRA2A polymorphism (rs1800544); CC genotype is associated with an increased sedative response compared with GC and GG. To date, this has not been studied in children. DESIGN We conducted a pilot study to determine whether ADRA2A genotype is associated with dexmedetomidine dose in children. MEASUREMENTS AND MAIN RESULTS Forty intubated PICU or CVICU patients who received dexmedetomidine as a continuous infusion for at least 2 days were genotyped for ADRA2A with a custom-designed TaqMan® Assay. Ten (25%) subjects were wildtype (GG), 15 (37.5%) were heterozygous (GC), and 15 (37.5%) were homozygous (CC) variant. The maximum dexmedetomidine doses (mCg/kg/h) were not different between genotype groups CC (1, 0.3-1.2), GC (1, 0.3-1.3), and GG (0.8, 0.3-1.2), (p = 0.37); neither were mean dexmedetomidine doses for these respective genotype groups 0.68 (0.24-1.07), 0.72 (0.22-0.98), 0.58 (0.3-0.94), (p = 0.67). CONCLUSIONS These findings did not confirm the results from adult studies where ADRA2A polymorphisms correlate with dexmedetomidine response, therefore highlighting the need for pediatric studies to validate PGx findings in adults prior to implementation in pediatrics.
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Affiliation(s)
- Katherine A. Gallaway
- Division of Clinical PharmacologyIndiana University School of MedicineIndianapolisIndianaUSA
| | - Todd C. Skaar
- Division of Clinical PharmacologyIndiana University School of MedicineIndianapolisIndianaUSA
| | - Ashwin Biju
- Division of Clinical PharmacologyIndiana University School of MedicineIndianapolisIndianaUSA
| | - James Slaven
- Department of Biostatistics and Health Data ScienceIndiana University School of MedicineIndianapolisIndianaUSA
| | - Emma M. Tillman
- Division of Clinical PharmacologyIndiana University School of MedicineIndianapolisIndianaUSA
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