Duration of analgesia and pruritus following intrathecal fentanyl for labour analgesia: no significant effect of A118G μ-opioid receptor polymorphism, but a marked effect of ethnically distinct hospital populations
Genetic polymorphism (A118G) in the μ-opioid receptor has been reported to affect systemic opioid analgesia. However, reported pharmacogenetic effects on spinal opioid analgesia, particularly in labour, have been equivocal. We prospectively assessed effects of the μ-opioid receptor A118G single nucl...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2013-09, Vol.111 (3), p.433-444 |
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| creator | Ginosar, Y Birnbach, D.J. Shirov, T.T. Arheart, K Caraco, Y Davidson, E.M. |
| description | Genetic polymorphism (A118G) in the μ-opioid receptor has been reported to affect systemic opioid analgesia. However, reported pharmacogenetic effects on spinal opioid analgesia, particularly in labour, have been equivocal.
We prospectively assessed effects of the μ-opioid receptor A118G single nucleotide polymorphism (SNP) on analgesia after 20 μg of spinal fentanyl. We studied two ethnically distinct hospital populations (Miami and Jerusalem). Independent variables were A118G, ethnicity, and hospital. Primary outcome was time from spinal analgesia until analgesic request. Secondary outcomes were pain and pruritus, assessed at repeated intervals until analgesia request.
One hundred and twenty-five nulliparous parturients in early labour were analysed. The allelic frequency of A118G was 14.8% (14.4% in Miami; 15.5% in Jerusalem). Time to analgesia request (sd) in Miami was 122 (44) min and in Jerusalem was 87 (32) min, P |
| doi_str_mv | 10.1093/bja/aet075 |
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We prospectively assessed effects of the μ-opioid receptor A118G single nucleotide polymorphism (SNP) on analgesia after 20 μg of spinal fentanyl. We studied two ethnically distinct hospital populations (Miami and Jerusalem). Independent variables were A118G, ethnicity, and hospital. Primary outcome was time from spinal analgesia until analgesic request. Secondary outcomes were pain and pruritus, assessed at repeated intervals until analgesia request.
One hundred and twenty-five nulliparous parturients in early labour were analysed. The allelic frequency of A118G was 14.8% (14.4% in Miami; 15.5% in Jerusalem). Time to analgesia request (sd) in Miami was 122 (44) min and in Jerusalem was 87 (32) min, P<0.001; Hispanic 123 (46) min vs Jew/Arab 87 (32) min, P<0.001; Black 121 (41) min vs Jew/Arab 87 (32) min, P=0.015. There was no significant effect of A118G. Survival analysis showed Miami > Jerusalem, P<0.001; Hispanics and Black > Jew/Arab, P<0.001; no effect of A118G. Within hospital groups, A118G had no effect on time to analgesic request; within genomic groups there was a significant difference between hospitals. The time-course for pruritus exactly paralleled the time-course for analgesia and was affected by hospital (P=0.006) and by ethnic group (P=0.03), but not by A118G.
We found no significant effect for the A118G single nucleotide polymorphism (SNP) on analgesic duration after spinal fentanyl for labour. In contrast, ethnically distinct hospital population groups exerted a marked effect on the time-course of both analgesia and pruritus.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aet075</identifier><identifier>PMID: 23592691</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; analgesia, obstetric ; Analgesia, Obstetrical - methods ; analgesics opioid, fentanyl ; Analgesics, Opioid - administration & dosage ; Analgesics, Opioid - adverse effects ; Analysis of Variance ; Ethnic Groups - statistics & numerical data ; Female ; Fentanyl - administration & dosage ; Fentanyl - adverse effects ; Florida - epidemiology ; genetic factors ; Humans ; Injections, Spinal - methods ; Polymorphism, Genetic - genetics ; Pregnancy ; Prospective Studies ; Pruritus - chemically induced ; Pruritus - epidemiology ; Pruritus - genetics ; Receptors, Opioid, mu - genetics ; Time Factors ; Young Adult</subject><ispartof>British journal of anaesthesia : BJA, 2013-09, Vol.111 (3), p.433-444</ispartof><rights>2013 The Author(s)</rights><rights>The Author [2013]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-3f997cbe44b8e797e7a5ff6281894d14991963bfbc18cdcd91a77f58094578423</citedby><cites>FETCH-LOGICAL-c398t-3f997cbe44b8e797e7a5ff6281894d14991963bfbc18cdcd91a77f58094578423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23592691$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ginosar, Y</creatorcontrib><creatorcontrib>Birnbach, D.J.</creatorcontrib><creatorcontrib>Shirov, T.T.</creatorcontrib><creatorcontrib>Arheart, K</creatorcontrib><creatorcontrib>Caraco, Y</creatorcontrib><creatorcontrib>Davidson, E.M.</creatorcontrib><title>Duration of analgesia and pruritus following intrathecal fentanyl for labour analgesia: no significant effect of A118G μ-opioid receptor polymorphism, but a marked effect of ethnically distinct hospital populations</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><addtitle>Br J Anaesth</addtitle><description>Genetic polymorphism (A118G) in the μ-opioid receptor has been reported to affect systemic opioid analgesia. However, reported pharmacogenetic effects on spinal opioid analgesia, particularly in labour, have been equivocal.
We prospectively assessed effects of the μ-opioid receptor A118G single nucleotide polymorphism (SNP) on analgesia after 20 μg of spinal fentanyl. We studied two ethnically distinct hospital populations (Miami and Jerusalem). Independent variables were A118G, ethnicity, and hospital. Primary outcome was time from spinal analgesia until analgesic request. Secondary outcomes were pain and pruritus, assessed at repeated intervals until analgesia request.
One hundred and twenty-five nulliparous parturients in early labour were analysed. The allelic frequency of A118G was 14.8% (14.4% in Miami; 15.5% in Jerusalem). Time to analgesia request (sd) in Miami was 122 (44) min and in Jerusalem was 87 (32) min, P<0.001; Hispanic 123 (46) min vs Jew/Arab 87 (32) min, P<0.001; Black 121 (41) min vs Jew/Arab 87 (32) min, P=0.015. There was no significant effect of A118G. Survival analysis showed Miami > Jerusalem, P<0.001; Hispanics and Black > Jew/Arab, P<0.001; no effect of A118G. Within hospital groups, A118G had no effect on time to analgesic request; within genomic groups there was a significant difference between hospitals. The time-course for pruritus exactly paralleled the time-course for analgesia and was affected by hospital (P=0.006) and by ethnic group (P=0.03), but not by A118G.
We found no significant effect for the A118G single nucleotide polymorphism (SNP) on analgesic duration after spinal fentanyl for labour. In contrast, ethnically distinct hospital population groups exerted a marked effect on the time-course of both analgesia and pruritus.</description><subject>Adult</subject><subject>analgesia, obstetric</subject><subject>Analgesia, Obstetrical - methods</subject><subject>analgesics opioid, fentanyl</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Analysis of Variance</subject><subject>Ethnic Groups - statistics & numerical data</subject><subject>Female</subject><subject>Fentanyl - administration & dosage</subject><subject>Fentanyl - adverse effects</subject><subject>Florida - epidemiology</subject><subject>genetic factors</subject><subject>Humans</subject><subject>Injections, Spinal - methods</subject><subject>Polymorphism, Genetic - genetics</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>Pruritus - chemically induced</subject><subject>Pruritus - epidemiology</subject><subject>Pruritus - genetics</subject><subject>Receptors, Opioid, mu - genetics</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctuVSEUhonR2GN14gMYJibGuC3sGxtnTavVpIkTHe-wYXEOlQPIRXPerc_g1NeRuutlYByxQr71wVo_Qo8peUkJ706WK3EiIBM23EEb2jPajIzRu2hDCGEN4bQ9Qg9SuiKEspYP99FR2w28HTndoO_nJYpsvMNeY-GE3UIyolYKh1iiySVh7a31X43bYuNypXcghcUaXBbuUAsfsRWLL_GP4BV2HiezdUYbKVzGoDXIfPPIKaXTBf523fhgvFE4goSQqyN4e9j7GHYm7V_gpWQs8F7ET6D-6oa8c9Vo7QErk7Jx9XrnUzC5fin4UOzPadJDdE8Lm-DR7XmMPr55_eHsbXP5_uLd2ellIzs-5abTnDO5QN8vEzDOgIlB67Gd6MR7RXvOKR-7RS-STlJJxalgTA8T4f3Apr7tjtGz1Rui_1wg5XlvkgRrhQNf0kz7diRknLquos9XVEafUgQ9h2jqgIeZkvkmyLkGOa9BVvjJrbcse1C_0V_JVeDpCvgS_i_qVw7qFr4YiHOSBpwEZerm86y8-VfbDxZyvys</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Ginosar, Y</creator><creator>Birnbach, D.J.</creator><creator>Shirov, T.T.</creator><creator>Arheart, K</creator><creator>Caraco, Y</creator><creator>Davidson, E.M.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Duration of analgesia and pruritus following intrathecal fentanyl for labour analgesia: no significant effect of A118G μ-opioid receptor polymorphism, but a marked effect of ethnically distinct hospital populations</title><author>Ginosar, Y ; Birnbach, D.J. ; Shirov, T.T. ; Arheart, K ; Caraco, Y ; Davidson, E.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-3f997cbe44b8e797e7a5ff6281894d14991963bfbc18cdcd91a77f58094578423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>analgesia, obstetric</topic><topic>Analgesia, Obstetrical - methods</topic><topic>analgesics opioid, fentanyl</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Analgesics, Opioid - adverse effects</topic><topic>Analysis of Variance</topic><topic>Ethnic Groups - statistics & numerical data</topic><topic>Female</topic><topic>Fentanyl - administration & dosage</topic><topic>Fentanyl - adverse effects</topic><topic>Florida - epidemiology</topic><topic>genetic factors</topic><topic>Humans</topic><topic>Injections, Spinal - methods</topic><topic>Polymorphism, Genetic - genetics</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>Pruritus - chemically induced</topic><topic>Pruritus - epidemiology</topic><topic>Pruritus - genetics</topic><topic>Receptors, Opioid, mu - genetics</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ginosar, Y</creatorcontrib><creatorcontrib>Birnbach, D.J.</creatorcontrib><creatorcontrib>Shirov, T.T.</creatorcontrib><creatorcontrib>Arheart, K</creatorcontrib><creatorcontrib>Caraco, Y</creatorcontrib><creatorcontrib>Davidson, E.M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ginosar, Y</au><au>Birnbach, D.J.</au><au>Shirov, T.T.</au><au>Arheart, K</au><au>Caraco, Y</au><au>Davidson, E.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Duration of analgesia and pruritus following intrathecal fentanyl for labour analgesia: no significant effect of A118G μ-opioid receptor polymorphism, but a marked effect of ethnically distinct hospital populations</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><stitle>Br J Anaesth</stitle><addtitle>Br J Anaesth</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>111</volume><issue>3</issue><spage>433</spage><epage>444</epage><pages>433-444</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><abstract>Genetic polymorphism (A118G) in the μ-opioid receptor has been reported to affect systemic opioid analgesia. However, reported pharmacogenetic effects on spinal opioid analgesia, particularly in labour, have been equivocal.
We prospectively assessed effects of the μ-opioid receptor A118G single nucleotide polymorphism (SNP) on analgesia after 20 μg of spinal fentanyl. We studied two ethnically distinct hospital populations (Miami and Jerusalem). Independent variables were A118G, ethnicity, and hospital. Primary outcome was time from spinal analgesia until analgesic request. Secondary outcomes were pain and pruritus, assessed at repeated intervals until analgesia request.
One hundred and twenty-five nulliparous parturients in early labour were analysed. The allelic frequency of A118G was 14.8% (14.4% in Miami; 15.5% in Jerusalem). Time to analgesia request (sd) in Miami was 122 (44) min and in Jerusalem was 87 (32) min, P<0.001; Hispanic 123 (46) min vs Jew/Arab 87 (32) min, P<0.001; Black 121 (41) min vs Jew/Arab 87 (32) min, P=0.015. There was no significant effect of A118G. Survival analysis showed Miami > Jerusalem, P<0.001; Hispanics and Black > Jew/Arab, P<0.001; no effect of A118G. Within hospital groups, A118G had no effect on time to analgesic request; within genomic groups there was a significant difference between hospitals. The time-course for pruritus exactly paralleled the time-course for analgesia and was affected by hospital (P=0.006) and by ethnic group (P=0.03), but not by A118G.
We found no significant effect for the A118G single nucleotide polymorphism (SNP) on analgesic duration after spinal fentanyl for labour. In contrast, ethnically distinct hospital population groups exerted a marked effect on the time-course of both analgesia and pruritus.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23592691</pmid><doi>10.1093/bja/aet075</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult analgesia, obstetric Analgesia, Obstetrical - methods analgesics opioid, fentanyl Analgesics, Opioid - administration & dosage Analgesics, Opioid - adverse effects Analysis of Variance Ethnic Groups - statistics & numerical data Female Fentanyl - administration & dosage Fentanyl - adverse effects Florida - epidemiology genetic factors Humans Injections, Spinal - methods Polymorphism, Genetic - genetics Pregnancy Prospective Studies Pruritus - chemically induced Pruritus - epidemiology Pruritus - genetics Receptors, Opioid, mu - genetics Time Factors Young Adult |
| title | Duration of analgesia and pruritus following intrathecal fentanyl for labour analgesia: no significant effect of A118G μ-opioid receptor polymorphism, but a marked effect of ethnically distinct hospital populations |
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