Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.04.005
Brazilian Journal of Anesthesiology
Original Investigation

The effect of alpha-2A adrenergic receptor (ADRA2A) genetic polymorphisms on the depth of sedation of dexmedetomidine: a genetic observational pilot study

O efeito dos polimorfismos genéticos do receptor adrenérgico alfa-2A (ADRA2A) na profundidade da sedação da dexmedetomidina: um estudo piloto observacional genético

Yoon Ji Choi, Kyu Hee Park, Ju Yeon Park, Won Kee Min, Yoon Sook Lee

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Abstract

Background
The genetic polymorphisms of the alpha-2A adrenergic receptor (ADRA2A), which plays a significant role in sedation, anxiety relief, and antinociception, particularly in dexmedetomidine, may differ in the degree of sedation. This study aimed to investigate the effect of the genetic polymorphisms of ADRA2A (rs11195418, rs1800544, rs2484516, rs1800545, rs553668, rs3750625) on the sedative effects of dexmedetomidine.

Methods
A total of 131 patients aged 50 years or more from May 2018 to August 2019 were included in this study. The ADRA2A gene variants were evaluated using the TaqMan Assay. Dexmedetomidine diluted in normal saline to a concentration of 4 μg.mL-1 was infused at a dose of 2 μg.kg-1 to achieve procedural sedation (modified Ramsay sedation scale 4 [mRSS 4]).

Results
A total of 131 patients were evaluated. The genetic polymorphisms (rs11195418) of the ADRA2A receptor gene demonstrated no variation in our participants. The ADRA2A receptor gene polymorphisms (rs1800544, rs2484516, rs1800545, rs553668, and rs3750625) exhibited no differences in total dexmedetomidine doses (p > 0.217), bispectral index at mRSS 4 (p > 0.620), and time to obtain mRSS 4 (p > 0.349).

Conclusion
This study suggested that the genetic polymorphisms of ADRA2A did not affect the sedative efficacy of dexmedetomidine.

Keywords

Adrenergic,  Alpha-2,  Dexmedetomidine,  Polymorphisms,  Sedation

Resumo

Introdução: Os polimorfismos genéticos do receptor adrenérgico alfa-2A (ADRA2A), que desempenha um papel significativo na sedação, no alívio da ansiedade e na antinocicepção, particularmente na dexmedetomidina, podem diferir no grau de sedação. Este estudo teve como objetivo investigar o efeito dos polimorfismos genéticos da ADRA2A (rs11195418, rs1800544, rs2484516, rs1800545, rs553668, rs3750625) sobre os efeitos sedativos da dexmedetomidina. Métodos: Um total de 131 pacientes com 50 anos ou mais de maio de 2018 a agosto de 2019 foram incluídos neste estudo. As variantes do gene ADRA2A foram avaliadas usando o ensaio TaqMan. Dexmedetomidina diluída em solução salina normal a uma concentração de 4 μg/mL foi infundida na dose de 2 μg/kg para obter sedação do procedimento (escala de sedação de Ramsay modificada 4 [mRSS 4]). Resultados: Foram avaliados 131 pacientes. Os polimorfismos genéticos (rs11195418) do gene do receptor ADRA2A não demonstraram variação em nossos participantes. Os polimorfismos do gene do receptor ADRA2A (rs1800544, rs2484516, rs1800545, rs553668 e rs3750625) não apresentaram diferenças nas doses totais de dexmedetomidina (p > 0,217), índice bispectral em mRSS 4 (p > 0,620) e tempo para obter mRSS 4 (p > 0,349). Conclusão: Este estudo sugeriu que os polimorfismos genéticos da ADRA2A não afetaram a eficácia sedativa da dexmedetomidina.

Palavras-chave

Adrenérgico; Alfa-2; Dexmedetomidina; Polimorfismos; Sedação

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