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 E...
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| Veröffentlicht in: | International journal of obstetric anesthesia 2012-01, Vol.21 (1), p.40-44 |
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| creator | Camorcia, M Capogna, G Stirparo, S Berritta, C Blouin, J.L Landau, R |
| description | 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 |
| doi_str_mv | 10.1016/j.ijoa.2011.10.001 |
| format | Article |
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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 <10 mm 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.</description><identifier>ISSN: 0959-289X</identifier><identifier>EISSN: 1532-3374</identifier><identifier>DOI: 10.1016/j.ijoa.2011.10.001</identifier><identifier>PMID: 22153130</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Analgesia, Epidural ; Analgesia, Obstetrical ; Analgesics, Opioid - administration & dosage ; Anesthesia & Perioperative Care ; Double-Blind Method ; Epidural ; Female ; Humans ; Labor analgesia ; Obstetrics and Gynecology ; Polymorphism ; Polymorphism, Single Nucleotide ; Pregnancy ; Receptors, Opioid, mu - genetics ; Sufentanil ; Sufentanil - administration & dosage ; μ-opioid receptor</subject><ispartof>International journal of obstetric anesthesia, 2012-01, Vol.21 (1), p.40-44</ispartof><rights>Elsevier Ltd</rights><rights>2011 Elsevier Ltd</rights><rights>Copyright © 2011 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-1f65f0f89d01555b5d722914c48dd2fa921cf5ba030a69d1479518dc4053935d3</citedby><cites>FETCH-LOGICAL-c410t-1f65f0f89d01555b5d722914c48dd2fa921cf5ba030a69d1479518dc4053935d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijoa.2011.10.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22153130$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Camorcia, M</creatorcontrib><creatorcontrib>Capogna, G</creatorcontrib><creatorcontrib>Stirparo, S</creatorcontrib><creatorcontrib>Berritta, C</creatorcontrib><creatorcontrib>Blouin, J.L</creatorcontrib><creatorcontrib>Landau, R</creatorcontrib><title>Effect of μ-opioid receptor A118G polymorphism on the ED50 of epidural sufentanil for labor analgesia</title><title>International journal of obstetric anesthesia</title><addtitle>Int J Obstet Anesth</addtitle><description>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 <10 mm 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.</description><subject>Adult</subject><subject>Analgesia, Epidural</subject><subject>Analgesia, Obstetrical</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Anesthesia & Perioperative Care</subject><subject>Double-Blind Method</subject><subject>Epidural</subject><subject>Female</subject><subject>Humans</subject><subject>Labor analgesia</subject><subject>Obstetrics and Gynecology</subject><subject>Polymorphism</subject><subject>Polymorphism, Single Nucleotide</subject><subject>Pregnancy</subject><subject>Receptors, Opioid, mu - genetics</subject><subject>Sufentanil</subject><subject>Sufentanil - administration & dosage</subject><subject>μ-opioid receptor</subject><issn>0959-289X</issn><issn>1532-3374</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2KFDEURgtRnJ7RF3Ah2bmq9t6kUl0BEYaxnREGXKjgLqTz46RMVcqkaqDfzWfwmUzRowsXbnLh8p0Pcm5VvUDYImD7ut_6PqotBcSy2ALgo2qDnNGasV3zuNqA4KKmnfh6Vp3n3AOAYF37tDqjtMSQwaZye-esnkl05NfPOk4-ekOS1XaaYyKXiN01mWI4DjFNdz4PJI5kvrNk_47DCtnJmyWpQPLi7Dir0QfiChnUobxqVOGbzV49q544FbJ9_jAvqi_v95-vburbj9cfri5va90gzDW6ljtwnTCAnPMDNztKBTa66YyhTgmK2vGDAgaqFQabneDYGd0AZ4Jxwy6qV6feKcUfi82zHHzWNgQ12rhkKbDltAPelCQ9JXWKOSfr5JT8oNJRIshVr-zlqleuetdd0Vuglw_1y2Gw5i_yx2cJvDkFbPnkvbdJZu3tqK3xReosTfT_73_7D66DH71W4bs92tzHJRWjWaLMVIL8tB54vS9iobFt2W8h1Z-_</recordid><startdate>20120101</startdate><enddate>20120101</enddate><creator>Camorcia, M</creator><creator>Capogna, G</creator><creator>Stirparo, S</creator><creator>Berritta, C</creator><creator>Blouin, J.L</creator><creator>Landau, R</creator><general>Elsevier Ltd</general><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>20120101</creationdate><title>Effect of μ-opioid receptor A118G polymorphism on the ED50 of epidural sufentanil for labor analgesia</title><author>Camorcia, M ; Capogna, G ; Stirparo, S ; Berritta, C ; Blouin, J.L ; Landau, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-1f65f0f89d01555b5d722914c48dd2fa921cf5ba030a69d1479518dc4053935d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Analgesia, Epidural</topic><topic>Analgesia, Obstetrical</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Anesthesia & Perioperative Care</topic><topic>Double-Blind Method</topic><topic>Epidural</topic><topic>Female</topic><topic>Humans</topic><topic>Labor analgesia</topic><topic>Obstetrics and Gynecology</topic><topic>Polymorphism</topic><topic>Polymorphism, Single Nucleotide</topic><topic>Pregnancy</topic><topic>Receptors, Opioid, mu - genetics</topic><topic>Sufentanil</topic><topic>Sufentanil - administration & dosage</topic><topic>μ-opioid receptor</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Camorcia, M</creatorcontrib><creatorcontrib>Capogna, G</creatorcontrib><creatorcontrib>Stirparo, S</creatorcontrib><creatorcontrib>Berritta, C</creatorcontrib><creatorcontrib>Blouin, J.L</creatorcontrib><creatorcontrib>Landau, R</creatorcontrib><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>International journal of obstetric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Camorcia, M</au><au>Capogna, G</au><au>Stirparo, S</au><au>Berritta, C</au><au>Blouin, J.L</au><au>Landau, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of μ-opioid receptor A118G polymorphism on the ED50 of epidural sufentanil for labor analgesia</atitle><jtitle>International journal of obstetric anesthesia</jtitle><addtitle>Int J Obstet Anesth</addtitle><date>2012-01-01</date><risdate>2012</risdate><volume>21</volume><issue>1</issue><spage>40</spage><epage>44</epage><pages>40-44</pages><issn>0959-289X</issn><eissn>1532-3374</eissn><abstract>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 <10 mm 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.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>22153130</pmid><doi>10.1016/j.ijoa.2011.10.001</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Analgesia, Epidural Analgesia, Obstetrical Analgesics, Opioid - administration & dosage Anesthesia & Perioperative Care Double-Blind Method Epidural Female Humans Labor analgesia Obstetrics and Gynecology Polymorphism Polymorphism, Single Nucleotide Pregnancy Receptors, Opioid, mu - genetics Sufentanil Sufentanil - administration & dosage μ-opioid receptor |
| title | Effect of μ-opioid receptor A118G polymorphism on the ED50 of epidural sufentanil for labor analgesia |
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