Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Seattle, WA 98195-6540, USA.
Clin Perinatol. 2013 Sep;40(3):575-87. doi: 10.1016/j.clp.2013.05.014. Epub 2013 Jun 27.
Studies on genetic contributions to labor analgesia have essentially evaluated the μ-opioid receptor gene (OPRM1), with some evidence that p.118A/G of OPRM1 influences the response to neuraxial opioids. As for labor progress, the β2-adrenergic receptor gene (ADRB2) is associated with preterm labor and delivery, and impacts the course of labor. Taken together though, there is no evidence that pharmacogenetic testing is needed or beneficial in the context of obstetric anesthesia; however, realizing the influence of genetic variants on specific phenotypes provides the rationale for a more cautious interpretation of clinical studies that attempt to find a dose-regimen that fits all.
对分娩镇痛的遗传贡献的研究主要评估了μ-阿片受体基因(OPRM1),有一些证据表明 OPRM1 的 p.118A/G 影响了对椎管内阿片类药物的反应。至于产程,β2-肾上腺素能受体基因(ADRB2)与早产和分娩有关,并影响产程。然而,总的来说,没有证据表明在产科麻醉的情况下需要或有益进行药物遗传学检测;但是,认识到遗传变异对特定表型的影响为更谨慎地解释试图找到适合所有情况的剂量方案的临床研究提供了依据。