Genetic Variants Account for Differences in Responses in Blood Pressure and Blood Flow Values to Laryngoscopy/Intubation/Extubation

Aim: There is a variation in drug response among individuals. In this study, we determined angiotensin-converting enzyme (ACE) insertion/deletion (I/D), beta2-adrenergic receptor (ADRB2) Arg16Gly and dopamine D1 receptor (DRD1) -48 G/A polymorphisms, which are presumed to be related to the transient hypertension induced by the mechanical stimulation of laryngoscopy and tracheal intubation/extubation. Materials and Methods: One hundred American Society of Anesthesiologists (ASA) class I patients were enrolled in this study. Heart rate and blood pressure were recorded before induction (T0), after induction (T1), during laryngoscopy/intubation (Ti) and 1, 2, 3, 4 and 5 min thereafter (Ti-1-Ti-5), before extubation (Te) and 1, 2, 3, 4 and 5 min afterwards (Te-1-Te-5). ACE I/D, ADRB2 Arg16Gly and DRD1 -48 G/A polymorphisms were investigated by polymerase chain reaction-restriction fragment length polymorphism analyses. Data were analyzed by Repeated Measure Factorial Analysis of Variance. Results: During laryngoscopy, intubation and extubation, blood pressure, heart rate and rate pressure product (RPP) values increased, returning to baseline within five minutes. Increases at Ti were significant for all values when compared to To (p

Genetic Variants Account for Differences in Responses in Blood Pressure and Blood Flow Values to Laryngoscopy/Intubation/Extubation

Aim: There is a variation in drug response among individuals. In this study, we determined angiotensin-converting enzyme (ACE) insertion/deletion (I/D), beta2-adrenergic receptor (ADRB2) Arg16Gly and dopamine D1 receptor (DRD1) -48 G/A polymorphisms, which are presumed to be related to the transient hypertension induced by the mechanical stimulation of laryngoscopy and tracheal intubation/extubation. Materials and Methods: One hundred American Society of Anesthesiologists (ASA) class I patients were enrolled in this study. Heart rate and blood pressure were recorded before induction (T0), after induction (T1), during laryngoscopy/intubation (Ti) and 1, 2, 3, 4 and 5 min thereafter (Ti-1-Ti-5), before extubation (Te) and 1, 2, 3, 4 and 5 min afterwards (Te-1-Te-5). ACE I/D, ADRB2 Arg16Gly and DRD1 -48 G/A polymorphisms were investigated by polymerase chain reaction-restriction fragment length polymorphism analyses. Data were analyzed by Repeated Measure Factorial Analysis of Variance. Results: During laryngoscopy, intubation and extubation, blood pressure, heart rate and rate pressure product (RPP) values increased, returning to baseline within five minutes. Increases at Ti were significant for all values when compared to To (p

___

  • 1. Hung O. Understanding hemodynamic responses to tracheal intubation. Can J Anaesth 2001; 48: 723-6.
  • 2. Kayhan Z, Aldemir D, Mutlu H, Ogus E. Which is responsible for the haemodynamic response due to laryngoscopy and endotracheal intubation? Catecholamines, vasopressin or angiotensin? Eur J Anaesthsiol 2005; 22: 780-5.
  • 3. Boralessa H, Senior D, Whitwam JG. Cardiovascular response to intubation. A comparative study of thiopentone and midazolam. Anesthesia 1983; 38: 623–7.
  • 4. Black T, Kay B, Healy E. Reducing the hemodynamic responses to laryngoscopy and intubation. Anesthesia 1984; 39: 883–7.
  • 5. Mikawa K, Maekawa N, Hasegawa M. Attenuation of the cardiovascular and catecholamine responses to tracheal intubation with oral guanabenz. Anaesth Analg 1993; 76: 585–91.
  • 6. Mikawa K, Nishina K, Maekawa N. Comparison of nicardipine, diltiazem and verapamil for controlling the cardiovascular responses to tracheal intubation. Br J Anaesth 1996; 76: 221–6.
  • 7. Zalunardo P, Zollinger A, Spahn D. Preoperative clonidine attenuated stress response during emergence from anesthesia. J Clin Anaesth 2000; 12: 343–9.
  • 8. Barak M, Ziser A, Greenberg A. Hemodynamic and catecholamine response to tracheal intubation: direct laryngoscopy compared with fiberoptic intubation. J Clin Anaesth 2002; 15: 132–6.
  • 9. Lasocki S, Iglarz M, Seince P-F, Vuillaumier-Barrot S, Vicaut E, Henrion D et al. Involvement of renin-angiotensin system in pressure-flow relationship. Anesthesiology 2002; 96: 271-5.
  • 10. Snieder H, Dong Y, Barbeau P, Harshfield GA, Dalageogou C, Zhu H et al. Beta2-adrenergic receptor gene and resting hemodynamics in European and African American youth. Am J Hypertens 2002; 11: 973-9.
  • 11. Kaymak C, Kocabas NA, Durmaz E, Oztuna D. Beta2 adrenoceptor (ADRB2) pharmacogenetics and cardiovascular phenotypes during laryngoscopy and tracheal intubation. Int J Toxicol 2006; 25: 443-9.
  • 12. Sato M, Soma M, Nakayama T. Dopamine D1 receptor gene polymorphism is associated with essential hypertension. Hypertension 2000; 36: 183–6.
  • 13. Miller SA, Dykes DD, Polesky HS. Simple salting out procedure for extracting DNA from human nucleated cells. Nuc Acid Res 1998; 20: 1433-40.
  • 14. Chang TJ, Tsai MH, Jiang YD, Lee B, Lee KC, Lin JY et al. The Arg16Gly polymorphism of human beta2 adrenoreceptor is associated with type 2 diabetes in Taiwanese people. Clin Endocrinol 2002; 57: 685-90.
  • 15. Yaren A, Turgut S, Kursunluoglu R, Oztop I, Turgut G, Kelten C et al. Association between the polymorphism of the angiotensinconverting enzyme gene and tumor size of breast cancer in premenopausal patients. Tohoku J Exp Med 2006; 210: 109-16.
  • 16. Kim NS, Lee IO, Lee MK, Lim SH, Choi YS, Kong MH. The effects of ß2 adrenoceptor gene polymorphisms on pressor response during laryngoscopy and tracheal intubation. Anesthesia 2002; 57: 227-32.
  • 17. Shribman A, Sm›th G, Achola K. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 1987; 59: 295–9.
  • 18. Akar N, Aras O, Omurlu K, Cin S. Deletion polymorphism at the angiotensin-converting enzyme gene in Turkish patients with coronary artery disease. Scand J Clin Lab Inves 1998; 58: 491-5.
  • 19. Bor-Kucukatay M, Turgut S, Emmungil G, Turgut G, Kucukatay V. Increased deformability of red blood cells is associated with a deletion polymorphism of the angiotensin-converting enzyme gene. Tohoku J Exp Med 2006; 208: 147-55.
  • 20. Talke P, Stapelfeldt C, Lobo E, Brown R, Scheinin M, Snapir A. Effect of a2B-adrenoceptor polymorphism on peripheral vasoconstriction in healthy volunteers. Anesthesiology 2005; 102: 536-42.
  • 21. Krushkal J, Xiong M, Ferrell R. Linkage and association of adrenergic and dopamine receptor genes in the distal portion of the long arm of chromosome 5 with systolic blood pressure variation. Hum Mol Gen 1998; 7: 1379-83.
  • 22. Henrion D, Benessiano J, Philip I, Vuillaumier-Barrot S, Iglarz M, Plantefeve G et al. The deletion genotype of the angiotensin Iconverting enzyme is associated with an increased vascular reactivity in vivo and in vitro. J Am Coll Cardiol 1999; 34: 830- 6
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Prevalence of Lower Urinary Tract Symptoms in Men Over 40 Years: A Cross-Sectional Study in Samsun

Sevgi CANBAZ, Cihat DÜNDAR, Şennur DABAK, Yıldız PEKŞEN, Ahmet Tevfik SÜNTER

A Real-Time Transthoracic Echocardiographic Imaging of Pulmonary Embolism in a Patient with Suspected Primary Antiphospholipid Syndrome

Mehmet Cengiz ÇOLAK, Hasan KOCATÜRK, Sebahattin ATEŞAL, Mustafa YILMAZ, Ednan BAYRAM

Plasma Thrombin Activitable Fibrinolysis Inhibitor Levels in Behçet´s Disease

Mehmet Ali ÖZCAN, Servet AKAR, İnci ALACACIOĞLU, Özden PİŞKİN

Genetic Variants Account for Differences in Responses in Blood Pressure and Blood Flow Values to Laryngoscopy/Intubation/Extubation

Fatma Belgin ATAÇ, Feride İffet ŞAHİN, Hülya GÖNEN, Ayşe Canan YAZICI, Zeynep KAYHAN

Quality Assurance Standards Task Force Global Standards: Route for Accreditation in Medical Education in Europe

Hans KARLE, İskender SAYEK

Is There a Correlation Between Extroversion Personality Characteristics of Medical Students and Awareness of Works of Art?

Dilek ASLAN, İskender SAYEK, Musacide Zehra ORDULU, Sare ALKAN, Yiğit SEZER, Emin SOYER

Effects of Esmolol on Hemodynamic Responses to Laryngoscopy and Tracheal Intubation in Diabetic Versus Non-Diabetic Patients

İsmet TOPÇU, Melek SAKARYA, Taner TAŞYÜZ, Sabri ÖZASLAN

Diagnostic Performance of QUS for Identifying Osteoporosis in Postmenopausal Turkish Women

Güzel DİŞÇİGİL, Cengiz CEYLAN, Ayfer GEMALMAZ

Effects of Acute Fenthion Toxicity on Liver and Kidney Function and Histology in Rats

Özgür EKİNCİ, Hatice PAŞAOĞLU, Mustafa KEREM, Abdülkadir BEDİRLİ, Ömer ŞAKRAK, Taylan AKKAYA, Nurdan BEDİRLİ, Neslihan GÜRBÜZ

Anesthesia for an Adult Patient with Congenital Diaphragmatic Eventration

Hülya BAŞAR, Solmaz GÜNAL, Hale Yarkan UYSAL, Ahmet Ş. UYAR