Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-23T01:37:48.749Z Has data issue: false hasContentIssue false
  • English
  • Français

Ethnic differences in propofol and fentanyl response: a comparison among Caucasians, Kenyan Africans and Brazilians

Published online by Cambridge University Press:  23 December 2004

O. Ortolani ,
A. Conti ,
Z. W. Ngumi ,
L. Texeira ,
P. Olang ,
I. Amani  and
V. C. Medrado
O. Ortolani
Affiliation:
Universita' di Firenze, Dipartimento di Area Critica Medico Chirurgica, Firenze
A. Conti
Affiliation:
Universita' di Napoli ‘Federico II’, Dipartimento di Biologia e Patologia Cellulare e Molecolare, Napoli, Italy
Z. W. Ngumi
Affiliation:
University of Nairobi, Department of Surgery, Kenyatta Hospital, Nairobi, Kenya
L. Texeira
Affiliation:
Hospital Universitario Sao Rafael, Chefia de Anesthesia, Salvador de Bahia, Brazil
P. Olang
Affiliation:
University of Nairobi, Department of Surgery, Kenyatta Hospital, Nairobi, Kenya
I. Amani
Affiliation:
University of Nairobi, Department of Surgery, Kenyatta Hospital, Nairobi, Kenya
V. C. Medrado
Affiliation:
Hospital Universitario Sao Rafael, Chefia de Anesthesia, Salvador de Bahia, Brazil
Get access

Extract

Summary

Background and objective: Differences in sensitivity to anaesthetic drugs may exist among human races. Allelic variants for drug metabolizing isoenzymes and other pharmacokinetic/pharmacodynamic differences may account for a variable response to anaesthetic drugs. This study was designed to investigate comparatively the anaesthetic requirements and the recovery trends of three different ethnic groups: Caucasians, African blacks and Brazilians.

Methods: The anaesthetic depth and recovery of groups of 45 patients undergoing total intravenous anaesthesia with propofol and fentanyl were compared. The bispectral index and clinical parameters were used to assess the depth of anaesthesia. The bispectral index, the response to verbal stimuli and the eye opening time were used to assess recovery.

Results: After stopping propofol, the bispectral index values of Caucasians returned to the baseline in about 10.8 ± 4 min, that of Kenyan African blacks in 18 ± 7 min and that of Brazilians in a highly variable time ranging from 5 to 25 min, (14.9 ± 9.9). The time from discontinuation of propofol and fentanyl infusion to eye opening was 18.8 ± 7.1 min in African blacks (P < 0.01) and 13.5 ± 8.8 min in Brazilians (P > 0.05) vs. 11.6 ± 4.5 min in Caucasians. Time to respond to verbal commands was 16.8 ± 8 min in African blacks (P < 0.01) and 12.8 ± 8.1 min in Brazilians (P > 0.05) vs. 9.9 ± 4.5 min in Caucasians.

Conclusions: The recovery of Kenyan African blacks from anaesthesia with propofol and fentanyl is much slower, in comparison with Caucasians. The recovery time of Brazilians is much more variable, in comparison with Caucasians.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolANALGESICS, OPIOID, fentanylANTHROPOLOGY, physical, racial stocks, Caucasoid race, Negroid raceCYTOCHROME P450 ENZYME SYSTEMPHARMACOGENETICSPHARMACOKINETICS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 4 , April 2004 , pp. 314 - 319
Copyright
2004 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Xie HG, Kim RB, Wood AJ, Stein CM. Molecular basis of ethnic differences in drug disposition and response. Annu Rev Pharmacol Toxicol 2001; 41: 815–850.Google Scholar
Ortolani O, Conti A, Sall-Ka B, et al. The recovery of Senegalese African blacks from intravenous anesthesia with propofol and remifentanil is slower than that of Caucasians. Anesth Analg 2001; 93: 1222–1226.Google Scholar
Rampil IJ. A primer for EEG signal processing in anesthesia. Anesthesiology 1998; 89: 980–1002.Google Scholar
Bradford LD. CYP2D6 allele frequency in European Caucasians, Asians, Africans and their descendants. Pharmacogenomics 2002; 3: 229–243.Google Scholar
Wennerholm A, Johansson I, Hidestrand M, Bertilsson L, Gustafsson LL, Ingelman-Sundberg M. Characterization of the CYP2D6*29 allele commonly present in a black Tanzanian population causing reduced catalytic activity. Pharmacogenetics 2001; 11: 417–427.Google Scholar
Isaza CA, Henao J, Lopez AM, Cacabelos R. Isolation, sequence and genotyping of the drug metabolizer CYP2D6 gene in the Colombian population. Meth Find Exp Clin Pharmacol 2000; 22: 695–705.Google Scholar
Sutherland L, Ebner T, Burchell B. The expression of UDP-glucuronosyltransferases of the UGT1 family in human liver and kidney and in response to drugs. Biochem Pharmacol 1993; 45: 295–301.Google Scholar
Simons PJ, Cockshott ID, Douglas EJ, Gordon EA, Knott S, Rouane RJ. Species differences in blood profiles, metabolism and excretion of 14C-propofol after intravenous dosing to rat, dog and rabbit. Xenobiotica 1991; 21: 1243–1256.Google Scholar
Court MH, Duan SX, Hesse LM, Venkatakrishnan K, Greenblatt DJ. Cytochrome P450 2B6 is responsible for interindividual variability of propofol hydroxylation by human liver microsomes. Anesthesiology 2001; 94: 110–119.Google Scholar
Favetta P, Degoute CS, Perdix JP, Dufresne C, Boulieu R, Guitton J. Propofol metabolites in man following induction and maintenance. Br J Anaesth 2002; 88: 653–658.Google Scholar
Vuyk J. Clinical interpretation of pharmacokinetic and pharmacodynamic propofol-opioid interactions. Acta Anaesthesiol Belg 2001; 52: 445–451.Google Scholar
Azevedo ES, Fortuna CM, Silva KM, et al. Spread and diversity of human populations in Bahia, Brazil. Hum Biol 1982; 54: 329–341.Google Scholar
Azevedo ES. Subgroup studies of black admixture within a mixed population of Bahia, Brazil. Ann Hum Genet 1980; 44: 55–60.Google Scholar