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2018 ; 9
(29
): 20294-20303
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Correlation of MDR1 gene polymorphism with propofol combined with remifentanil
anesthesia in pediatric tonsillectomy
#MMPMID29755652
Zhang Y
; Li Y
; Wang H
; Cai F
; Shen S
; Luo X
Oncotarget
2018[Apr]; 9
(29
): 20294-20303
PMID29755652
show ga
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 (0?min
after tracheal intubation), T2 (5 mins after the tracheal intubation), T3 (0?min
after the tonsillectomy), T4 (0?min after removal of the mouth-gag) and T5 (5?min
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 CT?+?TT
genotype of MDR1 1236C?>?T (all P?<.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 P?<.05). The visual analog
scale at 1, 2, 4, and 8?hours 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 P?<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 1236C?>?T CC genotype was
stronger than in those carrying the CT?+?TT genotype.