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Genet Test Mol Biomarkers. 2013 Oct;17(10):743-9. doi: 10.1089/gtmb.2013.0282. Epub 2013 Aug 2.

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

Author information

1
1 Department of Anesthesiology, Changzheng Hospital, Second Military Medical University , Shanghai, China .

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.

PMID:
23909491
DOI:
10.1089/gtmb.2013.0282
[Indexed for MEDLINE]

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