title: 2p24.1p23.2 deletion and delayed recovery after a general anesthesia for gastrointestinal endoscopic procedure.
abstract: Interstitial 2p deletions are very rare and may include proopiomelanocortin (POMC) gene (2p23.3). Our 10-year-old patient, known to carry this genetic anomaly, underwent an endoscopic interventional procedure under general anesthesia. After a sevoflurane induction, alfentanil (8.5 μg·kg-1) was given. The procedure lasted 22 min. There was an unexpected delayed recovery likely reflecting an unexpected delayed recovery likely due to opioid hypersensitivity. The deletion of POMC may cause a deficit in endorphin and may lead to an up-regulation of opioid receptors. Exogenous opioids should be used with particular caution in patients suffering a deficit of POMC.
authors.affiliation: Anesthesiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Guillaume
authors.identifier: http://orcid.org/0000-0003-0634-2557
authors.initials: G
authors.lastname: Dewé
authors.affiliation: Group of Neuropharmacology, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Hermans
authors.affiliation: Anesthesiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lavand'homme
mesh_terms: D015760:Alfentanil; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D002648:Child; D002889:Chromosomes, Human, Pair 2; D016099:Endoscopy, Gastrointestinal; D017353:Gene Deletion; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D011333:Pro-Opiomelanocortin / Q000235:genetics*; D000077149:Sevoflurane
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D015760:Alfentanil; D000077149:Sevoflurane; D011333:Pro-Opiomelanocortin
keywords: congenital; delayed emergence from anesthesia; deletion 2p; opioid; pediatric obesity; pharmacodynamics