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Abstract: Objective: This review discusses variability among patients in anesthesia, due to genetic polymorphisms. Data sources: Articles in French and English languages were retrieved from PubMed database. The initial request was “anesth* and (genotyp* or polymorphism* or genetic*)”. Study selection: Original articles, general reviews and one case report. Letters were excluded. Data extraction: Rare genetic diseases were excluded from the scope of this review. We stressed on frequent genetic polymorphisms that may have a daily impact in anesthesiology. Data synthesis: Most results were related to pain studies. We selected various examples to describe how genetic polymorphisms impacts the pharmacology of a given drug, and what are the clinical consequences. Conclusion: There is a growing field of pharmacogenetic related evidences in anesthesiology. The results from various animal and human studies underline the genetic origin of variability among individuals. How anaesthesists have to integrate these parameters for their daily practice is still unclear, but pharmacogenetic will obviously be a leading field of anesthesia research in the future. [Copyright &y& Elsevier]

Abstract: Objective: The aim of the present study was to compare the consumption and cost of ephedrine in parturients with respect to two packagings: ampoules and prefilled syringes. Study design: Prospective observational study in a French university obstetrical unit. Patients and methods: Assessing the consumption and cost of ephedrine during two consecutive periods of 14days: use of ampoules for period 1 (P1) versus use of prefilled syringes for period 2 (P2). Consumption was daily evaluated. The costs (ampoules and consumable supplies for P1 and prefilled syringes for P2) were calculated on the basis of the price list given by our institutional pharmacy. The number of parturients and the anaesthetic techniques which were performed were prospectively recorded. Results: One hundred and thirteen parturients were managed for the present study. The number of parturients and the anaesthetic care were similar between the two periods. In contrast, 155 ampoules were used for P1 versus 45 prefilled syringes for P2 (p <0.0001). The cost per parturient was 3.1€ for P1 versus 2.6€ for P2, i.e. 0.5€ was saved for each parturient. Conclusion: The results of the present study show that the use of prefilled syringes reduces significantly the wastage of ephedrine, allowing subsequent cost minimization in obstetrical anaesthesia. [Copyright &y& Elsevier]