The Effect of β2-Adrenoceptor Genotype on Phenylephrine Dose Administered During Spinal Anesthesia for Cesarean Delivery

Anesthesia and Analgesia
Lale OdekonRichard M Smiley

Abstract

The β2-adrenoceptor (ADRB2 gene) possesses several polymorphic sites that have physiologic and/or pharmacologic significance. Previous work has demonstrated that the ADRB2 genotype affects the amount of ephedrine administered to maintain blood pressure during cesarean delivery with spinal anesthesia. This study investigated whether the ADRB2 genotype affected phenylephrine dose requirements during cesarean delivery. Our hypothesis was that the ADRB2 genotype altered the ephedrine dose-response and that we would not see this effect if phenylephrine was the vasopressor used to maintain blood pressure because phenylephrine does not act via the β2-adrenoceptor. Women undergoing elective cesarean delivery were studied. Baseline systolic blood pressure (SBP) was determined, and spinal anesthesia was initiated with hyperbaric bupivacaine 12 mg, fentanyl 20 μg, and morphine 200 μg. Hypotension was treated with a phenylephrine infusion using a standardized algorithm (50 μg/min if SBP was 90%-99% of baseline, 100 μg/min for SBP 80%-89% baseline, and 200 μg/min plus boluses for SBP <80% baseline) for 15 minutes after the administration of spinal anesthesia. ADRB2 genotype at codons 16 and 27 was determined. The effect of genotype on admin...Continue Reading

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Citations

Jan 19, 2016·Annals of Medicine and Surgery·Arash Behrooz
Jun 20, 2017·Best Practice & Research. Clinical Anaesthesiology·Jennifer E LeeAshraf S Habib
Dec 16, 2020·International Journal of Obstetric Anesthesia·R Smiley

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