Effects of Genetic Polymorphisms of ABCB1 on the Efficacy of Anesthetic and Analgesic Agents: a Systematic Review

Abstract

Aim: To perform a systematic review to determine the effect of ABCB1 ( 1236C>T, 2677G>T/A and 3435C>T) variants on the effects of anesthetic and analgesic agents in various surgical procedures. Materials & methods: Literature was obtained from established databases and reference tracking. The main outcome measures were efficacy of anesthetic and analgesic agents intraoperative or within 48 h post surgery of human population. Results: Seventeen studies were included for data extraction from 1127 screened studies. The influences of ABCB1 gene polymorphisms on analgesic effects showed conflicting results. The mutational homozygous TT genotypes of 1236C>T and 3435C>T polymorphisms demonstrated significant association with the anesthetic effects. Conclusion: The mutational homozygous TT genotype in both ABCB1 1236C>T and 3435C>T is associated with weaker anesthetic effect but there are no clearly demonstrated analgesic effects.

Clinical Importance of Potential Genetic Determinants Affecting Propofol Pharmacokinetics and Pharmacodynamics

“…On the other hand, the mutation in ABCB1, SNP c.1236 C > T (rs1045642), was partly the reason for differences in the anesthetic effects when propofol was combined with remifentanil for pediatric tonsillectomy as reported by Zhang et al ( 51 ). Liew et al ( 52 ) used the databases PubMed, Medline, and Ovid to conduct a systematic search of the literature. The search was restricted to publications published between 2006 and 2020.…”