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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 1*
Anna Galletti 2
Marianna Lucafo' 1
Nagua Giurici 2
Debora Curci 2
Sara Solidoro 2
Valentina Kiren 2
Anna Monica Rosaria Bianco 2
Egidio Barbi 2
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
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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