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Anesth Analg 2008; 107:83-95
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31816a66a4
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ANESTHETIC PHARMACOLOGY

Sex-Specific Responses to Opiates: Animal and Human Studies

Albert Dahan, MD, PhD*, Benjamin Kest, PhD{dagger}, Amanda R. Waxman, MA{dagger}, and Elise Sarton, MD, PhD*

From the *Department of Anesthesiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; and {dagger}Department of Psychology, The City University of New York, New York.

Address correspondence and reprint requests to Prof. Dr. Albert Dahan, Department of Anesthesiology, Leiden University Medical Center, P5-Q, 2300 RC Leiden, The Netherlands. Address e-mail to a.dahan{at}lumc.nl.

It is widely reported that analgesic drugs acting at µ, {kappa}, and {delta} opioid-receptors display quantitative and qualitative differences in effect in males and females. These sex-related differences are not restricted to the analgesic/antinociceptive properties of opioids, but are also present in opioid-induced side effects, such as changes in respiration, locomotor activity, learning/memory, addiction, and changes in the cardiovascular system. An increasing number of well-controlled animal and human studies directly examining the issue of sex in the potency of opioids show that, although sex may affect opioid analgesia, the direction and magnitude of sex differences depend on many interacting variables. These include those specific to the drug itself, such as dose, pharmacology, and route and time of administration, and those particular to the subject, such as species, type of pain, genetics, age, and gonadal/hormonal status. In the current review, we systematically present these animal and human studies and discuss the data in relation to the depending variables. Although the observed sex differences in opioid effect may be clinically relevant, lack of knowledge on other factors involved in the large variability in patient opioid analgesic sensitivity should compel practitioners to customize their dosing regimens based on individual requirements.




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K. Gelb and A. W. Gelb
Sex and Gender in the Perioperative Period: Wake Up to Reality
Anesth. Analg., July 1, 2008; 107(1): 1 - 3.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.