Effects of genetic polymorphisms of OPRM1, ABCB1, CYP3A4/5 on postoperative fentanyl consumption in Korean gynecologic patients

Abstract

In Korean gynecologic patients, no association was found between genetic factors and postoperative fentanyl consumption.

How Much Oxycodone Is Needed for Adequate Analgesia After Breast Cancer Surgery: Effect of the OPRM1 118A>G Polymorphism

“…In Caucasian populations the effect has been smaller or non-existent. 4,11,21,40 The GG genotype is much rarer in the Caucasian population 21,26,40 compared with the Asian population 10,19,31 which may explain some of the difference. In addition, many of the negative studies have had small sample sizes 4, 9, 11 or a low frequency of the G-allele.…”

Polymorphism rs4263535 in GABRA1 intron 4 was related to deeper sedation by intravenous midazolam

“…16 The histidine residue in GABRA1 is characteristic of all major benzodiazepinesensitive GABA-A receptors. 17,18 Sedation, anterograde amnesia and the anticonvulsant effects produced by benzodiazepines are mediated via a1-containing GABA receptors, and anxiolysis and muscle relaxation are mediated by a2-containing GABA receptors. 14 Mutations to arginine residues in the a1, a2, a3, a5, b2, b3, and g2 subunits can produce a complete loss of potentiation of GABA-induced currents, thereby reducing benzodiazepine sensitivity.…”

The Impact of Genetics and Other Factors on Intra- and Post-partum Pain

“…While the influence of A118G genotype on intravenous (IV) fentanyl has been evaluated in several studies mostly in Asian patients in the context of post-operative analgesia [12][13][14][15][16][17][18], only one study examined its effect for early labor analgesia [19]. However, fentanyl is often offered in North America to women in early labor in an effort to delay or avoid receiving neuraxial analgesia.…”

“…Of importance, these findings of a pharmacogenetic effect of A118G on spinal fentanyl or epidural sufentanil, with lower dose requirements in laboring women with the G118 allele, are in disagreement with most if not all other studies examining the influence of A118G genotype and opioid analgesia [6], whether one evaluates post-operative IV fentanyl consumption [12][13][14][15][16][17][18], spinal morphine for post-cesarean pain [21,24,25], IV morphine for postoperative pain [26][27][28][29][30][31] or oral morphine for chronic cancer pain [5,32,33].…”

“…There are few clinical studies to date evaluating the influence of ABCB1 genotype on pain and opioid analgesia [5,16,28,30,52,64,65]. Most studies have not found ABCB1 genotype to be associated with major differences in pain outcomes, although P-gp activity is reduced in individuals TT homozygous for the C3435T polymorphism resulting in higher morphine CSF concentration [66] and potentially lower morphine consumption.…”