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rdf:type |
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lifeskim:mentions |
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pubmed:issue |
1
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pubmed:dateCreated |
2008-9-22
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pubmed:abstractText |
Labor initiates one of the most intensely painful episodes in a woman's life. Opioids are used to provide analgesia with substantial interindividual variability in efficacy. mu-Opioid receptor (muOR, OPRM1) genetic variants may explain differences in response to opioid analgesia. We hypothesized that OPRM1 304A/G polymorphism influences the median effective dose (ED(50)) of intrathecal fentanyl via combined spinal-epidural for labor analgesia. Nulliparous women were prospectively recruited around 35 weeks gestation (n=224), and genotyped for 304A/G polymorphism. Those requesting neuraxial labor analgesia were enrolled in one of the two double-blinded trials: up-down sequential allocation (SA, n=50) and a separate confirmatory random-dose allocation trial (RA, n=97). Effective analgesia from intrathecal fentanyl was defined by >or=60 min analgesia with verbal rating score <or=1 (scale 0-10) and was compared between mu OR 304A homozygotes (Group A) and women carrying at least one 304G allele (Group G). OPRM1 304G allele frequency f(-) was 0.18. Using SA, intrathecal fentanyl ED(50) was 26.8 microg (95% CI 22.7-30.9) in Group A and 17.7 microg (95% CI 13.4-21.9) in Group G (p<0.001; 304A homozygosity increased the ED(50) 1.5-fold). RA confirmed that 304A homozygosity significantly increases intrathecal fentanyl ED(50) (27.4 microg in Group A and 12.8 microg in Group G [p<0.002; 2.1-fold]). We demonstrate for the first time that the muOR 304G variant significantly reduces intrathecal fentanyl ED(50) for labor analgesia, suggesting women with the G variant may be more responsive to opioids and require less analgesic drugs. These findings for intrathecal fentanyl pharmacogenetics may have implications for patients receiving opioids in other settings.
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pubmed:grant |
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pubmed:commentsCorrections |
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-10201661,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-10211016,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-10523821,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-10861155,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11067846,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11388522,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11473872,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11535108,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11751037,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11773859,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11981144,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-11981152,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-12198062,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-12357145,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-12595695,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-12627468,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-12645995,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-12657859,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-14981031,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15041616,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15086512,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15087647,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15157710,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15321309,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15504181,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15537663,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15731588,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-15772909,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-16123758,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-16580900,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-16837133,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-16871067,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-16879459,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17000822,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17056970,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17151221,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17574758,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17583429,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17692462,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17877633,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-17898703,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-7574019,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-7905839,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-8895273,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-9141940,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-9505770,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-9689128,
http://linkedlifedata.com/resource/pubmed/commentcorrection/18403122-9743398
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
IM
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pubmed:chemical |
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pubmed:status |
MEDLINE
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pubmed:month |
Sep
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pubmed:issn |
1872-6623
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pubmed:author |
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pubmed:issnType |
Electronic
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pubmed:day |
30
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pubmed:volume |
139
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
5-14
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pubmed:dateRevised |
2009-11-18
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pubmed:meshHeading |
pubmed-meshheading:18403122-Adult,
pubmed-meshheading:18403122-Analgesia, Obstetrical,
pubmed-meshheading:18403122-Double-Blind Method,
pubmed-meshheading:18403122-Female,
pubmed-meshheading:18403122-Fentanyl,
pubmed-meshheading:18403122-Genetic Variation,
pubmed-meshheading:18403122-Genotype,
pubmed-meshheading:18403122-Humans,
pubmed-meshheading:18403122-Injections, Spinal,
pubmed-meshheading:18403122-Labor, Obstetric,
pubmed-meshheading:18403122-Pain Measurement,
pubmed-meshheading:18403122-Pregnancy,
pubmed-meshheading:18403122-Prospective Studies,
pubmed-meshheading:18403122-Receptors, Opioid, mu
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pubmed:year |
2008
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pubmed:articleTitle |
Genetic variability of the mu-opioid receptor influences intrathecal fentanyl analgesia requirements in laboring women.
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pubmed:affiliation |
Department of Anesthesia, University Hospital of Geneva, Geneva, Switzerland. ruth.landau@hcuge.ch
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pubmed:publicationType |
Journal Article,
Comparative Study
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