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Ginosar Y, Birnbach DJ, Shirov TT, et al. 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. Br J Anaesth. 2013;111(3):433-44doi: 10.1093/bja/aet075.
Ginosar, Y., Birnbach, D. J., Shirov, T. T., Arheart, K., Caraco, Y., & Davidson, E. M. (2013). 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. British journal of anaesthesia, 111(3), 433-44. https://doi.org/10.1093/bja/aet075
Ginosar, Y, et al. "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." British journal of anaesthesia vol. 111,3 (2013): 433-44. doi: https://doi.org/10.1093/bja/aet075
Ginosar Y, Birnbach DJ, Shirov TT, Arheart K, Caraco Y, Davidson EM. 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. Br J Anaesth. 2013 Sep;111(3):433-44. doi: 10.1093/bja/aet075. Epub 2013 Apr 16. PMID: 23592691.
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Br J Anaesth. 2013 Sep;111(3):433-44. doi: 10.1093/bja/aet075. Epub 2013 Apr 16.

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.

British journal of anaesthesia

Y Ginosar, D J Birnbach, T T Shirov, K Arheart, Y Caraco, E M Davidson

Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel. [email protected]

PMID: 23592691 DOI: 10.1093/bja/aet075

Abstract

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

Keywords: analgesia, obstetric; analgesics opioid, fentanyl; genetic factors.

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