title: A Case of Delayed Emergence After Propofol Anesthesia: Genetic Analysis.
abstract: This case report describes a 71-year-old woman who experienced unusual delayed emergence from propofol, which lasted for 3 hours and resulted in admission to the intensive care unit. Because genetic variations of propofol-metabolizing enzymes are proposed to be causal factors, we explored genetic polymorphisms of cytochrome P450 2B6 (CYP2B6) and uridine 5'-diphospho-glucuronosyltransferase 1A9 (UGT1A9). Suggested high-risk factors (advanced age, CYP2B6 516 G/T, and UGT1A9 I399 C/C) were observed in this case of delayed propofol metabolism. Therefore, genetic variants involved in propofol metabolism should be considered in unexplained delayed emergence.
authors.affiliation: From the *Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; and †the Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, Machida, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yonekura
authors.forename: Norie
authors.initials: N
authors.lastname: Murayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sobue
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000097:blood / Q000493:pharmacokinetics*; D065702:Cytochrome P-450 CYP2B6 / Q000235:genetics*; D004247:DNA / Q000097:blood / Q000235:genetics; D055191:Delayed Emergence from Anesthesia / Q000201:enzymology / Q000235:genetics*; D005260:Female; D005838:Genotype; D014453:Glucuronosyltransferase / Q000235:genetics*; D006801:Humans; D020641:Polymorphism, Single Nucleotide; D015742:Propofol / Q000097:blood / Q000493:pharmacokinetics*; D000090264:UDP-Glucuronosyltransferase 1A9
chemical_list: D018686:Anesthetics, Intravenous; C000715591:UGT1A9 protein, human; D004247:DNA; C585599:CYP2B6 protein, human; D065702:Cytochrome P-450 CYP2B6; D014453:Glucuronosyltransferase; D000090264:UDP-Glucuronosyltransferase 1A9; D015742:Propofol