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Effect of μ-opioid receptor A118G polymorphism on the ED50 of epidural sufentanil for labor analgesia.

Abstract：

BACKGROUND:A common polymorphism of the μ-opioid receptor gene (OPRM1, p.118A/G), which has been shown to effect the response to neuraxial opioids, occurs in 30% of Caucasian women. This double-blind up-down sequential allocation study was designed to examine the effect of p.118A/G on the ED50 of epidural sufentanil for labor analgesia. METHODS:Nulliparous women were recruited at 35 weeks of gestation (n=77) and genotyped for p.118A/G. Those subsequently requesting epidural labor analgesia were enrolled. Each woman received epidural sufentanil diluted with 0.9% saline to a volume of 5 mL. The initial sufentanil dose was 21 μg, with subsequent doses determined by the response of the previous patient (testing interval 1 μg). Efficacy was accepted if the visual analogue score decreased to <10mm on a 100-mm scale within 30 min of drug administration. RESULTS:Twenty patients were excluded, leaving 57 women from whom data were analyzed: 33 in Group A (wild-type A118 homozygotes) and 24 in Group G (heterozygotes and homozygotes G118). The ED50 for epidural sufentanil was 25.2 μg in Group A (95% CI 23.2-26.4) and 20.2 μg in Group G (95% CI 14.2-23.6) (P=0.03). The potency ratio for epidural sufentanil in Group G compared to Group A was 1.25 (95% CI 1.00-1.64). CONCLUSION:Women carrying the variant allele of p.118A/G of OPRM1 (G118) had a lower ED50 for epidural sufentanil given for early labor analgesia than women homozygous for the wild-type allele.

journal_name

Int J Obstet Anesth

journal_title

International journal of obstetric anesthesia

authors

Camorcia M,Capogna G,Stirparo S,Berritta C,Blouin JL,Landau R

doi

10.1016/j.ijoa.2011.10.001

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

40-4

issue

1

eissn

0959-289X

issn

1532-3374

pii

S0959-289X(11)00116-6

journal_volume

21

pub_type

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