Effects of OPRM1 A118G polymorphism on epidural analgesia with fentanyl during labor: a meta-analysis.

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  • Author(s): Song Z;Song Z; Du B; Wang K; Shi X
  • Source:
    Genetic testing and molecular biomarkers [Genet Test Mol Biomarkers] 2013 Oct; Vol. 17 (10), pp. 743-9. Date of Electronic Publication: 2013 Aug 02.
  • Publication Type:
    Journal Article; Meta-Analysis; Review
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 101494210 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1945-0257 (Electronic) Linking ISSN: 19450257 NLM ISO Abbreviation: Genet Test Mol Biomarkers Subsets: MEDLINE
    • Publication Information:
      Original Publication: New Rochelle, NY : Mary Ann Liebert, Inc.
    • Subject Terms:
      Analgesia, Epidural* ; Polymorphism, Genetic*; Analgesics, Opioid/*therapeutic use ; Fentanyl/*therapeutic use ; Labor, Obstetric/*genetics ; Pain, Postoperative/*genetics ; Receptors, Opioid, mu/*genetics; Alleles ; Clinical Trials as Topic ; Female ; Homozygote ; Humans ; Labor, Obstetric/drug effects ; Pain, Postoperative/drug therapy ; Pregnancy ; PubMed
    • Abstract:
      Background: Emerging evidence has shown that the most common polymorphism (A118G; rs1799971 A>G) in the μ-opioid receptor (OPRM1) gene may influence the response to labor analgesia, but individually published studies showed inconclusive results.
      Objective: This meta-analysis aimed to derive a more precise estimation of the effects of the OPRM1 A118G polymorphism on epidural analgesia with fentanyl during labor.
      Methods: A literature search was conducted on PubMed, Embase, Web of Science, and China BioMedicine databases before April 1st, 2013. The crude standardized mean difference (SMD) or odds ratio (OR) with 95% confidence interval (CI) was calculated.
      Results: Six clinical studies were included with a total 838 women who received epidural analgesia with fentanyl during labor. The meta-analysis results indicated that women carrying the G allele (AG+GG) of the OPRM1 A118G polymorphism required less fentanyl doses to achieve adequate pain relief compared with those with the AA homozygote (SMD=-0.24, 95% CI [-0.44, -0.03], p=0.022). The 118G variant was associated with a decreased ED50 of fentanyl for labor analgesia (SMD=-1.56, 95% CI [-1.97, -1.15], p<0.001). The analgesia satisfaction in women carrying the G allele (AG+GG) was higher than those with the AA homozygote (SMD=0.22, 95% CI [0.05, 0.39], p=0.012). However, there were no statistically significant differences between an AA homozygote and a G carrier (AG+GG) in the incidence of nausea and vomiting (OR=1.99, 95% CI [0.88, 4.52], p=0.101).
      Conclusion: In conclusion, the current meta-analysis indicates that women carrying the G allele (AG+GG) of OPRM1 A118G polymorphism may have a good response to epidural analgesia with fentanyl during labor. The OPRM1 A118G polymorphism may help predict individuals' response to epidural labor analgesia and so optimize postoperative pain control.
    • Accession Number:
      0 (Analgesics, Opioid)
      0 (OPRM1 protein, human)
      0 (Receptors, Opioid, mu)
      UF599785JZ (Fentanyl)
    • Publication Date:
      Date Created: 20130806 Date Completed: 20140418 Latest Revision: 20220408
    • Publication Date:
      20240104
    • Accession Number:
      10.1089/gtmb.2013.0282
    • Accession Number:
      23909491