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Randomized Controlled Trial Comparative Study
Genetic variability of the mu-opioid receptor influences intrathecal fentanyl analgesia requirements in laboring women.
- Ruth Landau, Christian Kern, Malachy O Columb, Richard M Smiley, and Jean-Louis Blouin.
- Department of Anesthesia, University Hospital of Geneva, Geneva, Switzerland. ruth.landau@hcuge.ch
- Pain. 2008 Sep 30;139(1):5-14.
AbstractLabor 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
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