Effect of MDR1 gene polymorphisms on neuromuscular block of rocuronium / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of MDR1 gene polymorphisms on the neuromuscular block of rocuronium. Methods One hundred thirty-five patients, aged 18-50 yr, with body mass index of 18-25 kg∕m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing gynecologic laparoscopic operation under general anesthesia, were enrolled in the study. Anesthesia was induced with midazolam 006 mg∕kg, sufentanil 07 μg∕kg, propofol(target plasma concentration 6 μg∕ml)and remifentanil(target plasma concentration 6 ng∕ml). After the patients lost consciousness, neuromuscular block was assessed with TOF-Watch SX accelerometer, and rocuronium 06 mg∕kg was intravenously injec-ted. Anesthesia was maintained by target-controlled infusion of propofol(target plasma concentration 3-5 μg∕ml)and remifentanil(target plasma concentration 3-6 ng∕ml). Rocuronium 015 mg∕kg was added when T1reached 25% of control. The onset time of rocuronium, maintenance time of induction dose, main-tenance time of additional dose and recovery index were recorded. Peripheral venous blood samples were collected for MDR1 genotype(MDR1 1236 C>T and 3435 C>T)analysis using polymerase chain reaction-restriction fragment length polymorphism. Results For MDR1 1236 C>T genotype, there were 19 cases of MDR1 1236 CC genotype, 72 cases of MDR1 1236 TT genotype, 44 cases of MDR1 1236 CT genotype. Compared with patients of MDR1 1236 CC, the maintenance time of induction dose, maintenance time of additional dose and recovery index were significantly prolonged in patients of MDR1 1236 TT and CT geno-types(P<005). For MDR1 3435 C>T genotype, there were 58 cases of MDR1 3435 CC genotype, 55 cases of MDR1 3435 TT genotype, 22 cases of MDR1 3435 TC genotype. There was no significant differ-ence in maintenance time of induction dose, maintenance time of additional dose and recovery index among patients of different MDR1 3435 C>T genotypes(P>005). Conclusion MDR1 1236 C>T gene poly-morphisms affects the neuromuscular block of rocuronium, and the genetic factor may be one of the reasons contributing to the individual variation in the efficacy.