Pharmacogenomic considerations for medications in the perioperative setting

Pharmacogenomics. 2019 Jul;20(11):813-827. doi: 10.2217/pgs-2019-0040.


Several high-profile examples of adverse outcomes from medications used in the perioperative setting are well known (e.g., malignant hyperthermia, prolonged apnea, respiratory depression, inadequate analgesia), leading to an increased understanding of genetic susceptibilities underlying these risks. Pharmacogenomic information is increasingly being utilized in certain areas of medicine. Despite this, routine preoperative genetic screening to inform medication risk is not yet standard practice. In this review, we assess the current readiness of pharmacogenomic information for clinical consideration for several common perioperative medications, including description of key pharmacogenes, pharmacokinetic implications and potential clinical outcomes. The goal is to highlight medications for which emerging or considerable pharmacogenomic information exists and identify areas for future potential research.

Keywords: analgesia; anesthesia; genetic markers; genomics; genotyping; perioperative; pharmacogenetics; pharmacogenomic; precision medicine; surgery.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / genetics*
  • Genetic Predisposition to Disease
  • Genetic Testing
  • Humans
  • Perioperative Care / trends*
  • Pharmacogenetics / trends*
  • Pharmacogenomic Testing*
  • Precision Medicine / trends