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.
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【Effects of OPRM1 A118G polymorphism on epidural analgesia with fentanyl during labor: a meta-analysis.].
【OPRM1 A118G基因多态性对芬太尼分娩时硬膜外镇痛的影响：荟萃分析。】
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DOI：10.1089/gtmb.2013.0282文章类型：杂志文章
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背景：新兴证据表明，μ阿片受体（OPRM1）基因中最常见的多态性（A118G; rs1799971 A> G）可能影响对分娩镇痛的反应，但个别发表的研究结果尚无定论。
目的：本荟萃分析旨在更准确地评估OPRM1 A118G基因多态性对芬太尼分娩时硬膜外镇痛的影响。
方法：在2013年4月1日之前在PubMed，Embase，Web of Science和中国生物医学数据库上进行文献检索。计算出具有95％置信区间（CI）的粗标准均差（SMD）或比值比（OR）。 。
结果：共进行了六项临床研究，共有838名在分娩期间接受芬太尼硬膜外镇痛的妇女。荟萃分析结果表明，与AA纯合子相比，携带OPRM1 A118G多态性的G等位基因（AG GG）的女性需要较少的芬太尼剂量才能获得足够的疼痛缓解（SMD = -0.24，95％CI [-0.44， -0.03]，p = 0.022）。 118G变体与用于分娩镇痛的芬太尼ED50降低有关（SMD = -1.56，95％CI [-1.97，-1.15]，p <0.001）。携带G等位基因（AG GG）的女性的镇痛满意度高于AA纯合子的女性（SMD = 0.22，95％CI [0.05，0.39]，p = 0.012）。但是，AA纯合子和G携带者（AG GG）在恶心和呕吐的发生率上没有统计学上的显着差异（OR = 1.99，95％CI [0.88，4.52]，p = 0.101）。
结论：总而言之，当前的荟萃分析表明，携带OPRM1 A118G多态性的G等位基因（AG GG）的妇女在分娩时对芬太尼硬膜外镇痛有良好的反应。 OPRM1 A118G基因多态性可以帮助预测个体对硬膜外分娩镇痛的反应，从而优化术后疼痛控制。
目的：本荟萃分析旨在更准确地评估OPRM1 A118G基因多态性对芬太尼分娩时硬膜外镇痛的影响。
方法：在2013年4月1日之前在PubMed，Embase，Web of Science和中国生物医学数据库上进行文献检索。计算出具有95％置信区间（CI）的粗标准均差（SMD）或比值比（OR）。 。
结果：共进行了六项临床研究，共有838名在分娩期间接受芬太尼硬膜外镇痛的妇女。荟萃分析结果表明，与AA纯合子相比，携带OPRM1 A118G多态性的G等位基因（AG GG）的女性需要较少的芬太尼剂量才能获得足够的疼痛缓解（SMD = -0.24，95％CI [-0.44， -0.03]，p = 0.022）。 118G变体与用于分娩镇痛的芬太尼ED50降低有关（SMD = -1.56，95％CI [-1.97，-1.15]，p <0.001）。携带G等位基因（AG GG）的女性的镇痛满意度高于AA纯合子的女性（SMD = 0.22，95％CI [0.05，0.39]，p = 0.012）。但是，AA纯合子和G携带者（AG GG）在恶心和呕吐的发生率上没有统计学上的显着差异（OR = 1.99，95％CI [0.88，4.52]，p = 0.101）。
结论：总而言之，当前的荟萃分析表明，携带OPRM1 A118G多态性的G等位基因（AG GG）的妇女在分娩时对芬太尼硬膜外镇痛有良好的反应。 OPRM1 A118G基因多态性可以帮助预测个体对硬膜外分娩镇痛的反应，从而优化术后疼痛控制。
