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CASE REPORT article

Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1549540

Post-Procedure Sedation and Apnea Linked to Ion Channel Variant: A Case Report on Dexmedetomidine-Propofol Interaction

Provisionally accepted
Gabriele Stocco Gabriele Stocco 1*Anna Galletti Anna Galletti 2Marianna Lucafo' Marianna Lucafo' 1Nagua Giurici Nagua Giurici 2Debora Curci Debora Curci 2Sara Solidoro Sara Solidoro 2Valentina Kiren Valentina Kiren 2Anna Monica Rosaria Bianco Anna Monica Rosaria Bianco 2Egidio Barbi Egidio Barbi 2Pio D'Adamo Pio D'Adamo 2
  • 1 University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
  • 2 Institute for Maternal and Child Health Burlo Garofolo (IRCCS), Trieste, Friuli-Venezia Giulia, Italy

The final, formatted version of the article will be published soon.

    We report a case of post-awakening recurrent episodes of spontaneous re-sedation and apnea with severe desaturation after procedural sedation with dexmedetomidine and propofol, in a leukemic adolescent with an ionic channel variant. The mutation is located in the 3-UTR regulatory region of SCN9A. We speculate that this variant may affect the stability of the mRNA, making the patient more susceptible to the combined effects of propofol and dexmedetomidine. This is the first pediatric report of late onset re-sedation with apnoea after combined sedation with propofol and dexmedetomidine highlighting the risk of adverse events in selected patients with a genetic increased susceptibility. If validated by further studies, pharmacogenetic testing may be implemented to provide personalized therapies in patients needing anesthesia.

    Keywords: post awakening apnea, Re-sedation, Dexmedetomidine, Propofol, SCN9A gene variant

    Received: 21 Dec 2024; Accepted: 04 Feb 2025.

    Copyright: © 2025 Stocco, Galletti, Lucafo', Giurici, Curci, Solidoro, Kiren, Bianco, Barbi and D'Adamo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gabriele Stocco, University of Trieste, Trieste, 34127, Friuli-Venezia Giulia, Italy

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