PGx anaesthesia and pain

Synonyms: -

Material:

EDTA blood
(1 ml), buccal swab

TAT:

10-15 days

Method:

NGS, amplicon-based

Overview

Inherited variation in pharmacogenes can influence the efficacy, tolerability and safety of selected analgesic and anaesthetic treatments. This panel covers six pharmacogenes relevant to pain management, anaesthesia and perioperative care (CYP2D6, CYP2C9, CYP2B6, BCHE, RYR1 and CACNA1S). The included genes can be analysed either as part of the panel or individually for specific indications.

PGx anaesthesia and pain

6 Gene(s)*

BCHE

CACNA1S

CYP2B6

CYP2C9

CYP2D6

RYR1

Pharmacological background

Tested variants

Result interpretation

Test limitations

Clinical relevance

Indication	ICD—10	Gene	OMIM
Drug intolerance	T88.7	CYP2D6	124030
Therapy resistance	T88.7	CYP2D6	124030
Drug intolerance	T88.7	CYP2C9	601130
Drug intolerance	T88.7	CYP2C19	124020
Therapy resistance	T88.7	CYP2C19	124020

References

Crews KR, Monte AA, Huddart R, Caudle KE, Kharasch ED, Gaedigk A, et al. Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6, OPRM1, and COMT genotypes and select opioid therapy. Clin Pharmacol Ther. 2021;110(4):888-896. PMID: .
Theken KN, Lee CR, Gong L, Caudle KE, Formea CM, Gaedigk A, et al. Clinical Pharmacogenetics Implementation Consortium guideline (CPIC) for CYP2C9 and nonsteroidal anti-inflammatory drugs. Clin Pharmacol Ther. 2020;108(2):191-200. PMID: .
Wang PF, Sharma A, Montana M, Neiner A, Juriga L, Reddy KN, et al. Methadone pharmacogenetics in vitro and in vivo: metabolism by CYP2B6 polymorphic variants and genetic variability in paediatric disposition. Br J Clin Pharmacol. 2022;88(11):4881-4893. PMID: .
Robinson KM, Eum S, Desta Z, Tyndale RF, Gaedigk A, Crist RC, et al. Clinical Pharmacogenetics Implementation Consortium guideline for CYP2B6 genotype and methadone therapy. Clin Pharmacol Ther. 2024;116(4):932-938. PMID: .
Wichmann S, Færk G, Bundgaard JR, Gätke MR. Patients with prolonged effect of succinylcholine or mivacurium had novel mutations in the butyrylcholinesterase gene. Pharmacogenet Genomics. 2016;26(7):351-356. PMID: .
Swissmedic. Mivacron (mivacurium) Fachinformation. Zulassung 52290. Stand December 2025. Available from:
Gonsalves SG, Dirksen RT, Sangkuhl K, Pulk R, Alvarellos M, Vo T, et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for the use of potent volatile anesthetic agents and succinylcholine in the context of RYR1 or CACNA1S genotypes. Clin Pharmacol Ther. 2019;105(6):1338-1344. PMID: .
Liu A, Delgado Rolón VM, Nahrwold DA. Delayed diagnosis of butyrylcholinesterase deficiency with insufficient neuromuscular monitoring and a confounding effect of SedLine® brain function monitoring: a case report. BJA Open. 2022;3:100089. PMID: .
US Food and Drug Administration. QUELICIN (succinylcholine chloride) prescribing information. NDA008845, version 30. Label effective May 25, 2026. Available from:
Swissmedic. Co-Dafalgan (paracetamol/codeine) Fachinformation. Zulassung 47353. Kontraindikationen. Stand March 2026. Available from:

Created by

Our editorial team consists of medical specialists and scientists in the field of human genetics. All content is created and reviewed in accordance with current scientific standards.

Last content review: August 4, 2026. As pharmacogenomic evidence and recommendations continue to evolve, the information presented on this page may not always reflect the latest updates. For current guidance and annotations, please refer to .

Last Update : 24.09.2026

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