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Correlation of MDR1 gene polymorphism with propofol combined with remifentanil anesthesia in pediatric tonsillectomy

YunLong Zhang1, Yongpei Li2, Hongfa Wang1

  • 1Department of Anesthesiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.

Oncotarget
|May 15, 2018
PubMed

Insights

The MDR1 1236C>T CC genotype is linked to stronger anesthetic effects in children undergoing tonsillectomy. This genetic variation influences anesthetic recovery times and physiological responses post-surgery.

Area of Science:

  • Pharmacogenetics
  • Anesthesiology
  • Pediatric Surgery

Background:

  • The MDR1 gene, encoding P-glycoprotein, plays a crucial role in drug transport and metabolism.
  • Genetic variations in MDR1 can influence the efficacy and safety of various anesthetic agents.
  • Understanding these interactions is vital for optimizing anesthetic management in pediatric procedures.

Purpose of the Study:

  • To investigate the association between MDR1 gene polymorphisms (2677 G>T/A, 1236 C>T, 3435 C>T) and anesthetic effects in children undergoing tonsillectomy.
  • To evaluate the impact of these polymorphisms on hemodynamic parameters, recovery, and pain assessment post-anesthesia.

Main Methods:

  • A cohort of 240 children undergoing tonsillectomy with propofol-remifentanil anesthesia was studied.
  • Genomic DNA was extracted to analyze MDR1 gene polymorphisms (2677 G>T/A, 1236 C>T, 3435 C>T) using direct sequencing.
  • Hemodynamic data (MAP, DBP, SBP, HR), recovery times (induction, eye-opening, extubation), pain scores (VAS, FLACC), and sedation scores (Ramsay) were recorded.

Main Results:

  • Children with the MDR1 1236C>T CC genotype exhibited shorter induction, respiration recovery, eye-opening, and extubation times compared to CT+TT genotypes (P < .05).
  • Hemodynamic parameters (MAP, DBP, SBP, HR) were significantly reduced at 5 minutes post-extubation in the CC genotype group (P < .05).
  • VAS pain scores and FLACC scores indicated altered pain perception, and Ramsay sedation scores were lower in the CC genotype group post-extubation (P < .05).

Conclusions:

  • The MDR1 1236C>T polymorphism influences anesthetic effects in pediatric tonsillectomy patients.
  • The CC genotype of MDR1 1236C>T is associated with a stronger anesthetic effect, characterized by faster recovery and altered physiological responses.
  • These findings highlight the potential of pharmacogenetics in tailoring anesthetic strategies for pediatric patients.

Keywords:
multidrug resistance genepropofolremifentanilsingle nucleotide polymorphismtonsillectomy

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