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Purpose: Propofol anesthesia is usually accompanied by hypotensive responses, which are at least in part mediated by nitric oxide (NO). Arginase I (ARG1) and arginase II (ARG2) compete with NO synthases for their common substrate L-arginine, therefore influencing the NO formation. We examined here whether ARG1 and ARG2 genotypes and haplotypes affect the changes in blood pressure and NO bioavailability in response to propofol.
Methods: Venous blood samples were collected from 167 patients at baseline and after 10 min of anesthesia with propofol. Genotypes were determined by polymerase chain reaction. Nitrite concentrations were measured by using an ozone-based chemiluminescence assay, while NO (nitrites + nitrates) levels were determined by using the Griess reaction.
Results: We found that patients carrying the AG + GG genotypes for the rs3742879 polymorphism in ARG2 gene and the ARG2 GC haplotype show lower increases in nitrite levels and lower decreases in blood pressure after propofol anesthesia. On the other hand, subjects carrying the variant genotypes for the rs10483801 polymorphism in ARG2 gene show more intense decreases in blood pressure (CA genotype) and/or higher increases in nitrite levels (CA and AA genotypes) in response to propofol.
Conclusion: Our results suggest that ARG2 variants affect the hypotensive responses to propofol, possibly by modifying NO bioavailability.
Trial Registration: NCT02442232.
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http://dx.doi.org/10.1007/s00228-020-03059-9 | DOI Listing |
Patients with cardiovascular compromise are likely to develop hypotension upon receiving even small doses of sedatives. On the other hand, patients with severe dental phobias or with intellectual disability who have a severe gag reflex often require deeper levels of anesthesia. Thus, achieving an optimal level of anesthesia can be difficult in patients with cardiovascular compromise because of the relatively narrow range of sedative dosing capable of providing sufficient sedation to prevent the gag reflex without compromising hemodynamics.
View Article and Find Full Text PDFCureus
August 2025
Emergency Medicine, Stockport NHS Foundation Trust, Stockport, GBR.
Kounis syndrome, also known as allergic myocardial infarction, is a rare but potentially life-threatening condition in which acute coronary events are triggered by an allergic reaction. The pathophysiology involves mast cell degranulation and the release of inflammatory mediators such as histamine, leukotrienes, and platelet-activating factor, leading to coronary vasospasm, myocardial ischemia, or infarction. We present the case of a female patient in her 80s with no prior history of coronary artery disease who developed anaphylaxis shortly after intravenous administration of co-amoxiclav in the emergency department.
View Article and Find Full Text PDFExp Dermatol
September 2025
Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan.
Radiation dermatitis is a common side effect of radiotherapy, affecting up to 95% of cancer patients receiving radiation therapy and often leading to skin damage, inflammation, and ulceration. The pathogenesis of radiation dermatitis involves complex mechanisms, such as the production of reactive oxygen species (ROS) and sustained inflammatory responses. Current treatments, including topical steroids, moisturisers, and non-steroidal anti-inflammatory drugs (NSAIDs), often provide limited efficacy, primarily addressing symptoms rather than the underlying pathophysiological processes.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
October 2025
Department of Anesthesia and Perioperative Medicine, Western University.
Introduction: Current commercial cerebral oximeters only monitor the frontal lobes, however, some cerebrovascular territories may experience ischemia while others remain well perfused. This pilot study used a novel, high-density, dual-wavelength, time-resolved functional cerebral oximeter (Kernel Flow) with 2000 channels to assess the regional differences of cerebral oxygenation (StO2) in response to hypotension across different vascular territories during shoulder surgery in the beach chair position.
Methods: Twenty-seven adult patients were monitored, recording blood pressure, heart rate, regional cerebral oxygen saturation, and other vital parameters.
Clin Auton Res
September 2025
Faculty of Medicine, Department of Medicine, Ageing and Age-Associated Disorders Research Group, Division of Geriatric Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Background: Orthostatic hypotension (OH) is prevalent in older adults and is often associated with falls. However, the presence or absence of symptoms in OH may be mediated by cerebral autoregulation, which helps maintain cerebral perfusion during blood pressure fluctuations.
Methods: We recruited 40 older adults (aged ≥ 55 years) from the Malaysian Elders Longitudinal Research (MELoR) cohort.