Journal article
Observational study of the effect of μ-opioid receptor genetic polymorphism on intrathecal opioid labor analgesia and post-cesarean delivery analgesia
International journal of obstetric anesthesia, Vol.19(3), pp.246-253
2010
DOI: 10.1016/j.ijoa.2009.09.005
PMID: 20171873
Abstract
The purpose of this two-part prospective observational and blinded trial was to determine whether the single nucleotide polymorphism of the μ-opioid receptor gene (OPRM1:c.304A>G) modifies (1) the duration of intrathecal fentanyl labor analgesia and (2) supplemental analgesic requirements after intrathecal morphine analgesia following cesarean delivery.
Labor analgesia was initiated with intrathecal fentanyl 25 μg. Patients undergoing primary cesarean delivery under spinal anesthesia received intrathecal morphine 150 μg. The primary outcome variables were duration of intrathecal fentanyl analgesia in the labor study and the requirement for supplemental systemic analgesia in the cesarean study. Outcomes were compared between 304A homozygotes (group A) and 304A>G heterozygotes and 304G homozygotes (group G).
The labor study included 190 participants and the post-cesarean study included 103 participants; 24% subjects carried the 304A>G allele. The median (95% CI) duration of intrathecal fentanyl analgesia was 70 min (62, 78) in group A and 63 min (50, 76) in group G (
P = 0.54). There was no difference in the amount of supplemental oral morphine equivalents required to treat breakthrough pain within 72 h after intrathecal morphine between groups A and G (median [IQR] 68 mg (37, 97) and 75 mg (37, 90) respectively,
P = 0.99) or in the duration of intrathecal morphine analgesia (
P = 0.84). The incidence of pruritus was greater in group A.
Using the two outcome parameters duration of analgesia and treatment for breakthrough pain, we did not find a simple association between intrathecal opioid analgesia and OPRM1 304A/G polymorphism.
Details
- Title: Subtitle
- Observational study of the effect of μ-opioid receptor genetic polymorphism on intrathecal opioid labor analgesia and post-cesarean delivery analgesia
- Creators
- C.A Wong - Northwestern University Feinberg School of Medicine, Chicago, IL, USAR.J McCarthy - Northwestern University Feinberg School of Medicine, Chicago, IL, USAJ Blouin - University of Geneva, Geneva, SwitzerlandR Landau - University of Geneva, Geneva, Switzerland
- Resource Type
- Journal article
- Publication Details
- International journal of obstetric anesthesia, Vol.19(3), pp.246-253
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.ijoa.2009.09.005
- PMID
- 20171873
- ISSN
- 0959-289X
- eISSN
- 1532-3374
- Language
- English
- Date published
- 2010
- Academic Unit
- Anesthesia
- Record Identifier
- 9984006464602771
Metrics
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