Perioperative outcome: genetics, environment or both?

Abstract

In some individuals, response to stress of surgery, anaesthesia or intensive care treatment, may differ of predicted outcome. While pharmacogenetics studies inherited variation in drug metabolism and differences in response to drugs, pharmacogenomics means wide population genomic testing for genetic variation. Toxicogenomics and ecogenomics investigate genomic changes as results of, or the effects of drugs, either environmental pollutants, respectively. Different responses to drugs used in anaesthesia represent consequence of genetic background an individual patient brings, as well as environmental influences he/she has been exposed to, psychological state, or different patient’s habits. Gene products interact with, and their expression and function is affected by a variety of environmental factors (nutrition, alcohol, smoking, environmental xenobiotics, pathogens, chronic disease, other medications and stressful life events). This gene- environment interaction is reflected by individual differences in all aspects of health and disease, including responses to drugs and stress related to anaesthesia.