• Can J Anaesth · Apr 2015

    Randomized Controlled Trial Multicenter Study

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

    Red-haired patients show no greater risk of intraoperative awareness than other phenotypes.

    • Stephen C Gradwohl, Amrita Aranake, Arbi Ben Abdallah, Paul McNair, Nan Lin, Bradley A Fritz, Alex Villafranca, David Glick, Eric Jacobsohn, George A Mashour, and Michael S Avidan.
    • Department of Anesthesiology, Washington University in Saint Louis, School of Medicine, Campus Box 8054, 660 S. Euclid Ave., Saint Louis, MO, 63110, USA.
    • Can J Anaesth. 2015 Apr 1;62(4):345-55.

    PurposeThe 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.MethodsIn 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 T(2) 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.ResultsA 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.ConclusionThere 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.

      Pubmed     Full text   Copy Citation  

      Add institutional full text...

    This article appears in the collection: Debunking anesthetic myths.



    Red-haired patients show no greater risk of intraoperative awareness than other phenotypes.

    Daniel Jolley  Daniel Jolley
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..