Pharmacogenetic and pharmacokinetic factors for dexmedetomidine-associated hemodynamic instability in pediatric patients

The reported incidence of hemodynamic instability for dexmedetomidine (DEX) sedation exceeds 50%. The risk of hemodynamic instability caused by DEX necessitates a better understanding of its pharmacogenetics in young children. The purpose of this study was to investigate the factors that associated with DEX-induced hemodynamic instability. As a result, genetic variants in UGT2B10, CYP2A6, ADRA2B, CACNA2D2, NR1I2 and CACNB2 influenced the incidence of DEX-induced hemodynamic instability, and polymorphism analyses in associated genes might be beneficial to optimize DEX treatment. Hemodynamic instability is likely to occur after 35-min DEX initiation in patients with lower DEX clearance after propofol induction.