Pharmacogenomics is the study of genetic variants that impact drug effects through changes in a drug’s pharmacokinetics and pharmacodynamics. Pharmacogenomics is being integrated into clinical pain management practice because variants in individual genes can be predictive of how a patient may respond to a drug treatment. Pain is subjective and is considered challenging to treat. Furthermore, pain patients do not respond to treatments in the same way, which makes it hard to issue a consistent treatment regimen for all pain conditions. Pharmacogenomics would bring consistency to the subjective nature of pain and could revolutionize the field of pain management by providing personalized medical care tailored to each patient based on their gene variants. Additionally, pharmacogenomics offers a solution to the opioid crisis by identifying potentially opioid-vulnerable patients who could be recommended a nonopioid treatment for their pain condition. The integration of pharmacogenomics into clinical practice creates better and safer healthcare practices for patients. In this article, we provide a comprehensive history of pharmacogenomics and pain management, and focus on up to date information on the pharmacogenomics of pain management, describing genes involved in pain, genes that may reduce or guard against pain and discuss specific pain management drugs and their genetic correlations.
Clinical pharmacology has changed many clinical systems, including anaesthesia delivery in both the hospital and ambulatory surgery settings. Ambulatory surgery centres, also known as outpatient care centres, are facilities that provide same-day healthcare services to patients, which are costeffective and convenient. These facilities can offer surgical care, intervention, and diagnostic and preventative procedures (Figure 1). Ambulatory surgery centres may choose to perform procedures in one specific specialty or instead offer a broad range of services. These facilities are revolutionary because they provide an alternative to hospital-based outpatient services and generally provide favourable patient outcomes. Ambulatory surgery centres have increased across the USA, related to the expansion of minimally invasive and noninvasive procedures and advances in anaesthesia and analgesia with im-
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