Department of Anesthesiology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Anaesthesiology, Linhe District People's Hospital, Bayannur, Inner Mongolia, China.
Korean J Anesthesiol. 2023 Apr;76(2):89-98. doi: 10.4097/kja.22654. Epub 2022 Dec 5.
Responses to sedatives, analgesics and muscle relaxants vary among patients under general anesthesia, which could be ascribed to the disparities of clinical characteristics and genetic factors of individuals. Accumulating researches have indicated that gene polymorphisms of the receptors, transporters and metabolizing enzymes associated with anesthetics play a considerable role in their efficacy. However, a systematically summarized study on the mechanisms of gene polymorphisms on pharmacodynamics and pharmacokinetics of anesthetics is still lacking. In this paper, the recent researches on pharmacogenomics of sedatives, analgesics and muscle relaxants are comprehensively reviewed, and the contributions and mechanisms of polymorphisms to the differences of individual efficacy of these drugs are discussed, so as to provide guidance for the formulation of a rational anesthesia regimen for patients with various genotypes.
全麻患者对镇静剂、镇痛药和肌肉松弛剂的反应存在个体差异,这可能与个体的临床特征和遗传因素的差异有关。越来越多的研究表明,与麻醉剂相关的受体、转运体和代谢酶的基因多态性在其疗效中起着相当大的作用。然而,关于基因多态性对麻醉药药效学和药代动力学影响的系统总结研究仍然缺乏。本文综合回顾了镇静剂、镇痛药和肌肉松弛剂的药物基因组学研究进展,讨论了多态性对这些药物个体疗效差异的贡献和机制,以期为制定各种基因型患者的合理麻醉方案提供指导。