Challenges in anesthesia personalization: resolving the pharmacogenomic puzzle

Per Med. 2019 Nov;16(6):511-525. doi: 10.2217/pme-2019-0056. Epub 2019 Nov 6.

Abstract

Clinicians are witnessing differences in the doses required for induction and maintenance of anesthesia, as well as prolonged recovery in some patients. Predictable factors like patient characteristics, factors related to the procedure, pharmacological characteristics of anesthetics and adjunctive drugs, might explain some of the observed differences. However, the role of various polymorphisms of genes encoding for drugs' molecular targets, transporters and metabolic enzymes can have a significant impact on anesthesia outcome, too. In the present paper, we critically discuss pharmacological characteristics of the most common drugs used in anesthesia, with a focus on the possible genetic background of unpredictable diversities in anesthesia outcomes.

Keywords: anesthesia; epigenetics; genotype; inhalational anesthetics; intravenous anesthetics; neuromuscular blockers; opioids; pharmacological characteristics; sedatives.

Publication types

  • Review

MeSH terms

  • Analgesics / pharmacology
  • Anesthesia / methods*
  • Anesthetics, Inhalation / pharmacology
  • Anesthetics, Intravenous / pharmacology
  • Epigenomics
  • Genetics
  • Humans
  • Hypnotics and Sedatives / pharmacology
  • Pharmacogenetics / methods*
  • Pharmacogenetics / trends*
  • Precision Medicine / methods

Substances

  • Analgesics
  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Hypnotics and Sedatives