Intraoperative awareness risk, anesthetic sensitivity, and anesthetic management for patients with natural red hair: a matched cohort study

Abstract

Purpose The red-hair phenotype, which is often produced by mutations in the melanocortin-1 receptor gene, has been associated with an increase in sedative, anesthetic, and analgesic requirements in both animal and human studies. Nevertheless, the clinical implications of this phenomenon in red-haired patients undergoing surgery are currently unknown. Methods In a secondary analysis of a prospective trial of intraoperative awareness, red-haired patients were identified and matched with five control patients, and the relative risk for intraoperative awareness was determined. Overall anesthetic management between groups was compared using Hotelling’s T2 statistic. Inhaled anesthetic requirements were compared between cohorts by evaluating the relationship between end-tidal anesthetic concentration and the bispectral index with a linear mixed-effects model. Time to recovery was compared using Kaplan-Meier analysis, and differences in postoperative pain and nausea/vomiting were evaluated with Chi square tests. Results A cohort of 319 red-haired patients was matched with 1,595 control patients for a sample size of 1,914. There were no significant differences in the relative risk of intraoperative awareness (relative risk = 1.67; 95% confidence interval 0.34 to 8.22), anesthetic management, recovery times, or postoperative pain between red-haired patients and control patients. The relationship between pharmacokinetically stable volatile anesthetic concentrations and bispectral index values differed significantly between red-haired patients and controls (P < 0.001), but without clinical implications. Conclusion There were no demonstrable differences between red-haired patients and controls in response to anesthetic and analgesic agents or in recovery parameters. These findings suggest that perioperative anesthetic and analgesic management should not be altered based on self-reported red-hair phenotype.

Red hair and anesthetic requirement

“…22 ont évalué différentes mesures de la sensibilité aux anesthésiques dans une cohorte prospective de patients. Ils ont trouvé que les roux et un groupe apparié de patients contrôles avaient reçu des quantités semblables d'anesthésiques volatils, d'opioïdes et d'adjuvants anesthésiques.…”

“…Subjects with the mutation were also more than twice as likely to avoid dental care as participants without MC1R gene variants, even after controlling for general trait anxiety and sex. 21 In this issue of the Journal, Gradwohl et al 22 describe a secondary analysis of patients drawn from a previously published study of anesthetic awareness in patients at high risk for recall. 23 In their current analysis, the investigators compared four anesthetic characteristics in 319 self-reported redheads and 1,595 propensity-matched patients with other hair colours.…”

“…In summary, Gradwohl et al 22 evaluated various measures of anesthetic sensitivity in a prospective cohort of patients. They found that redheads and a matched group of control patients were given similar amounts of volatile anesthetics, opioids, and anesthetic adjuvants.…”

Association Between the ABO Blood Types and Post-operative Pain

“…19,20 Other genetic factors such as gender, ethnicity and hair colour are also associated with pain sensitivity. [21][22][23] For instance, female gender and people of younger age were found to be associated with higher post-operative pain scores. 17 Therefore, these factors must be considered when planning postoperative medication plans.…”

Analgesia y anestesia en pelirrojos, ¿alguna precaución especial?

“…analgesia", "adverse drug reaction". Se analizaron todos los artículos desde 1985 hasta (1)(2)(3)(4)(5). Hace más de una década hubo trabajos que apoyaron esta teoría de una diferente sensibilidad a los anestésicos, sin embargo no ha sido confirmada por los trabajos recientes.…”