A Case of Delayed Emergence After Propofol Anesthesia: Genetic Analysis

A A Case Rep. 2016 Dec 1;7(11):243-246. doi: 10.1213/XAA.0000000000000397.


This case report describes a 71-year-old woman who experienced unusual delayed emergence from propofol, which lasted for 3 hours and resulted in admission to the intensive care unit. Because genetic variations of propofol-metabolizing enzymes are proposed to be causal factors, we explored genetic polymorphisms of cytochrome P450 2B6 (CYP2B6) and uridine 5'-diphospho-glucuronosyltransferase 1A9 (UGT1A9). Suggested high-risk factors (advanced age, CYP2B6 516 G/T, and UGT1A9 I399 C/C) were observed in this case of delayed propofol metabolism. Therefore, genetic variants involved in propofol metabolism should be considered in unexplained delayed emergence.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anesthetics, Intravenous / blood
  • Anesthetics, Intravenous / pharmacokinetics*
  • Cytochrome P-450 CYP2B6 / genetics*
  • DNA / blood
  • DNA / genetics
  • Delayed Emergence from Anesthesia / enzymology
  • Delayed Emergence from Anesthesia / genetics*
  • Female
  • Genotype
  • Glucuronosyltransferase / genetics*
  • Humans
  • Polymorphism, Single Nucleotide*
  • Propofol / blood
  • Propofol / pharmacokinetics*
  • UDP-Glucuronosyltransferase 1A9


  • Anesthetics, Intravenous
  • UGT1A9 protein, human
  • DNA
  • CYP2B6 protein, human
  • Cytochrome P-450 CYP2B6
  • Glucuronosyltransferase
  • UDP-Glucuronosyltransferase 1A9
  • Propofol