title: Maternal and neonatal effects of remifentanil in women undergoing cesarean section in relation to ABCB1 and OPRM1 polymorphisms.
abstract: The aim of our study was to evaluate possible effect of ABCB1, and OPRM1 polymorphisms on the efficacy and safety of remifentanil in women undergoing elective cesarean section under general anesthesia. Women received remifentanil (1 microg/kg i.v.) 30 s prior to the induction to standardized general anesthesia. The ABCB1 (rs2032582, rs1045642) and OPRM1 (rs1799971) polymorphisms were analyzed from maternal peripheral blood. The basal hemodynamic and demographic parameters in the study population (n=54) were similar in all the subgroups. The median +/- SD increase of systolic blood pressure at 5 min from the baseline was practically completely abolished in homozygous carriers of ABCB1 variants in comparison with wild-type subjects -2.67+/-25.0 vs. 16.57+/-15.7 mm Hg, p<0.05 for rs2032582, and 2.00+/-23.9 vs. 22.13+/-16.8 mm Hg, p<0.05, for rs1045642, respectively. While no neonate belonging to ABCB1 wild-type homozygous or OPRM1 variant carrying mothers needed any resuscitative measure, 10.5 % of the neonates belonging to OPRM1 wild-type homozygous mothers received resuscitative support similarly as 11.1 %, and 12.5 % of neonates of mothers carrying variants of rs2032582, and rs1045642, respectively. Decreased stabilizing effects of remifentanil on maternal hemodynamics has been observed in ABCB1 wild type mothers, while the adaptation of the neonates was clinically worse in OPRM1 wild type, and ABCB1 variant allele carriers.
authors.affiliation: Institute of Pharmacology, First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Prague, Czech Republic. hana.vondrackova@centrum.cz.
authors.forename: H
authors.initials: H
authors.lastname: Bakhouche
authors.forename: P
authors.initials: P
authors.lastname: Noskova
authors.forename: S
authors.initials: S
authors.lastname: Svetlik
authors.forename: O
authors.initials: O
authors.lastname: Bartosova
authors.forename: J
authors.initials: J
authors.lastname: Ulrichova
authors.forename: J
authors.initials: J
authors.lastname: Kubatova
authors.forename: P
authors.initials: P
authors.lastname: Marusicova
authors.forename: A
authors.initials: A
authors.lastname: Parizek
authors.forename: J
authors.initials: J
authors.lastname: Blaha
authors.forename: O
authors.initials: O
authors.lastname: Slanar
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics; D000328:Adult; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011247:Pregnancy; D017450:Receptors, Opioid, mu / Q000235:genetics*; D000077208:Remifentanil; D016896:Treatment Outcome
chemical_list: C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D018686:Anesthetics, Intravenous; C485764:OPRM1 protein, human; D010880:Piperidines; D017450:Receptors, Opioid, mu; D000077208:Remifentanil