Document Detail


Evaluation of the influence of the codon 16 polymorphism of the Beta-2 adrenergic receptor gene on the incidence of arterial hypotension and ephedrine use in pregnant patients submitted to subarachnoid anesthesia.
MedLine Citation:
PMID:  20682155     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: The beta-2 adrenergic receptor gene has several polymorphisms. Recent studies have demonstrated the clinical importance of the latter. The objective of the present study was to evaluate the influence of the Arg16Gli polymorphism on the incidence of arterial hypotension and ephedrine use in pregnant patients submitted to subarachnoid block for Cesarean section.
METHOD: Healthy parturients (ASA I and II) were submitted to subarachnoid anesthesia for elective Cesarean section (n = 50). Ephedrine was administered in cases of arterial hypotension. The incidence of arterial hypotension and the required dose of ephedrine to correct the arterial pressure were compared between the different genotypes identified.
RESULTS: The most prevalent genotype was Arg16Gli (60%, n = 30) followed by Gli16Gli (26%, n = 13) and Arg16Arg (14%, n = 7). No differences were observed regarding the basic characteristics of the genotypes. In comparison to the Arg16Arg genotype, the Gli16Gli presented a 3.95-fold increase in the hazard ratio of arterial hypotension (95%CI 0.86-18.11; p = 0.076), whereas the Arg16Gli presented a 4.83-fold increase (95%CI 1.13-20.50; p = 0.033). The parturients with the Arg16Arg needed, on average, 6.4 +/- 8.5 mg of ephedrine to correct the arterial hypotension, whereas those with the Arg16Gli needed 19.5 +/- 15.9 mg (p = 0.0445; 95%CI 0.3325-25.78) and the ones with the Gli16Gli genotype, 19.2 +/- 14.3 (p = 0.0445, 95%CI 0.3476-25.26).
CONCLUSIONS: The results show that the genetic variant Arg16Arg presents a lower incidence of arterial hypertension and that lower doses of ephedrine were necessary to reestablish normal arterial pressure in the patients with this genetic profile. We conclude that the Arg16Arg genotype confers better pressure stability to the parturients submitted to subarachnoid anesthesia for Cesarean section.
Authors:
Edno Magalhães; Maurício Daher Andrade Gomes; Gustavo Barcelos Barra; Cátia Sousa Govêia; Luis Cláudio Araújo Ladeira
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista brasileira de anestesiologia     Volume:  60     ISSN:  1806-907X     ISO Abbreviation:  Rev Bras Anestesiol     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-08-04     Completed Date:  2011-01-06     Revised Date:  2014-02-05    
Medline Journal Info:
Nlm Unique ID:  0401316     Medline TA:  Rev Bras Anestesiol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  228-36     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Editora Ltda. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Obstetrical*
Anesthesia, Spinal*
Cesarean Section
Codon / genetics
Ephedrine / therapeutic use*
Female
Humans
Hypotension / epidemiology*,  genetics*
Incidence
Polymorphism, Genetic*
Pregnancy
Receptors, Adrenergic, beta-2 / genetics*
Vasoconstrictor Agents / therapeutic use*
Young Adult
Chemical
Reg. No./Substance:
0/Codon; 0/Receptors, Adrenergic, beta-2; 0/Vasoconstrictor Agents; GN83C131XS/Ephedrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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