Impact of genetic variations on the pharmacokinetics, dose requirements, and clinical effects of propofol: a systematic review

Abstract

Introduction: Both the dose requirements and side-effects of propofol vary significantly between individuals. Propofol is primarily metabolised by uridine 5ʹ-diphosphate-glucuronosyltransferase (UGT) and cytochrome P450 (CYP) enzymatic pathways, specifically UGT1A9 (70%) and CYP2B6/CYP2C9 (29%). Genetic polymorphisms, which influence enzyme transcription and function, can influence propofol metabolism and propofol clearance and thereby potentially impact anaesthesia-related clinical outcomes. Pharmacogenomic testing can assist with individualising propofol dosing during total intravenous anaesthesia (TIVA) to improve safety and efficacy. This systematic review evaluates the impact of metabol..