Pharmacogenetics of Ketamine-Induced Emergence Phenomena: A Pilot Study.
Edwin N Aroke, Sybil L. Crawford, Jennifer R Dungan
Nursing Research 2017 DOI: 10.1097/nnr.0000000000000197 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional pharmacogenetic candidate gene pilot study Peer reviewed |
|---|---|
| Sample size | 75 |
| Population | Patients having minor elective outpatient surgeries; 47 received ketamine and were genotyped |
| Intervention | Ketamine |
| Measures | Clinician Administered Dissociative State Scale |
| Topics | Esketamine Ketamine |
| Key findings | Ketamine-induced emergence phenomena were not associated with CYP2B6*6 or GRIN2B single-nucleotide polymorphisms in this pilot sample. Exploratory analysis found that younger age, higher ketamine dose, and longer duration of anesthesia significantly predicted EP occurrence and severity. The authors estimate 380 to 570 cases would be needed to adequately power future genetic association studies. |
Abstract
Up to 55% of patients who are administered ketamine experience an emergence phenomena (EP) that closely mimics schizophrenia and increases their risk of injury; however, to date, no studies have investigated genetic association of ketamine-induced EP in healthy patients. The aim of the study was to investigate the feasibility and sample sizes required to explore the relationship between CYP2B6*6 and GRIN2B single-nucleotide polymorphisms and ketamine-induced EP. This cross-sectional, pharmacogenetic candidate, gene pilot study recruited 75 patients having minor elective outpatient surgeries. EP was measured with the Clinician Administered Dissociative State Scale. Genetic association of CYP2B6*6 and GRIN2B (rs1019385 and rs1806191) single-nucleotide polymorphisms and ketamine-induced EP occurrence and severity were tested using logistic and linear regression. Forty-seven patients (63%) received ketamine and were genotyped, and 40% of them experienced EP. Occurrence and severity of EP were not associated with CYP2B6*6 or GRIN2B (p > .10). Exploratory analysis of nongenotype models containing age, ketamine dose, duration of anesthesia, and time from ketamine administration to assessment for EP significantly predicted EP occurrence (p = .001) and severity (p = .007). This pilot study demonstrates feasibility for implementing a pharmacogenetic study in a clinical setting, and we estimate that between 380 and 570 cases will be needed to adequately power future genetic association studies. Younger age, higher dose, and longer duration of anesthesia significantly predicted EP occurrence and severity among our pilot sample. Although the small sample size limited our ability to demonstrate significant genotype differences, we generated effect sizes, sample size estimates, and nongenetic covariates information in order to support future pharmacogenetic study design for evaluating this adverse event.
Comparable studies
Other non-randomized and open-label trials on ketamine, most cited first.
Citations in the library
Cited by 2
Cites 7
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