The aim of this study
Is to investigate if GABRγ2 Genetic variant (or Single nucleotide polymorphism SNP) rs211037 and an intronic nucleotide number rs2279020 polymorphism from A to G, is associated with EA after Sevoflurane anesthesia in Preschool children.
Patients and Methods
This study included 60 pre-school children, ASA I, of both sexes who underwent lower abdominal surgery, anesthetized by Sevoflurane and caudal blockade. At emergence, children were assessed for EA every 5 min, in PACU by Watcha scale1: (0: Asleep, 1: calm, 2: crying, can be consoled, 3: crying, cannot be consoled, or 4: agitated and thrashing). Children were divided into 2 groups. Gr.I: Non-agitated children; scored (0, 1 or 2) Gr.2: Agitated children; scored (3 or 4). GABA receptor gene polymorphisms rs211037 and intronic rs2279020 were genotyped by PCR-RFLP.
Results
GABRγ2 rs211037 stratified the cases into wild homozygous CC in (65%) and Heterozygous CT in (35%) of children, none of the cases was homozygous mutant (TT). The two groups showed insignificant EA between them. The intronic polymorphism rs2279020, however, was heterozygous AG in 73.3% of the cases; it was associated with EA in 54.50% of children versus 9 % in AA and 0.0% in GG Introns, ( < 0.001).
Conclusion
There was high incidence of EA in children with genetic intronic variant GABRγ2 (SNP) rs2279020 (A/G) after Sevoflurane anesthesia.
Emergence agitation (EA) is very common in Preschool children who receive Sevoflurane anesthesia. The GABA receptors are the target effect site of Sevoflurane.