Association between ABCB1 gene polymorphisms and fentanyl's adverse effects in Turkish patients undergoing spinal anesthesia |
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Authors: | Kesimci E Engin A B Kanbak O Karahalil B |
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Institution: | a Ataturk Training and Research Hospital, Anesthesiology and Intensive Care Department, Ankara, Turkeyb Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey |
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Abstract: | The ATP-binding cassette transporter (ABCB1) gene product, P-glycoprotein plays an important role in the prevention of intracellular accumulation of potentially toxic substances and metabolites in various tissues. Single nucleotide polymorphisms in this gene are claimed to be correlated with changes in the function of P-glycoprotein. There is evidence that fentanyl, may be a substrate for P-glycoprotein. The aim of the study was to assess whether an association exists between ABCB1 gene polymorphism and early respiratory and sedative adverse effects of intravenous fentanyl in Turkish patients who underwent spinal anesthesiaIn all 83 unrelated Turkish patients were enrolled in this study. In this study, spinal anesthesia was provided and a single dose of intravenous fentanyl (2.5 μg.kg−1) at the beginning of surgery was used as a sedative agent. Bispectral index, respiration rate and peripheral oxygen saturation were measured continuously and recorded throughout the study.The allele and genotype frequencies were similar to previous data from Turkish population.Respiratory rate (RR) and SpO2 parameters of the patients did not show any significant difference according to the genotype distribution for C1236T and C3435T SNPs. Fentanyl-induced decrease in respiration rate was most remarkable at 15 min (23%) in CC genotype of C1236T, whereas in TT genotype of C3435T (18%) polymorphism. SpO2 parameters in allele distribution were also not significant among the groups (p = 0.374, p = 0.985, respectively). For the C1236T polymorphism, patients carrying T allele showed a significant decrease in pH, and a significant increase in pCO2 (p < 0.001).ABCB1 polymorphisms did not seem to have a significant effect on sedation and respiratory depression caused by intravenous fentanyl in spinal anesthesia in Turkish patients. |
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Keywords: | ABCB1 ATP-binding casette transporter µ g kg-1 micrograms/kilograms RR respiratory rate SpO2 peripheral oxygen saturation pCO2 partial pressure of CO2 pH colog [H+] SNP single nucleotide polymorphism ASA American Society of Anesthesiologists ABG arterial blood gas BIS bispectral index OAA/S Observer&rsquo s Assessment And Alertness Scale PCR Polymerase Chain Reaction bp base pair |
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