Department of Anaesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Anaesthesia. 2010 Feb;65(2):130-5. doi: 10.1111/j.1365-2044.2009.06193.x. Epub 2009 Dec 9.
One hundred and seventy-four Chinese gynaecology patients were studied for the impact of A118G polymorphism in the micro-opioid receptor gene (OPRM1) on pain sensitivity and postoperative fentanyl consumption. Pre-operatively, the pain threshold and pain tolerance threshold were measured using electrical stimulation. A118G polymorphism was genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. Intravenous fentanyl patient-controlled analgesia provided postoperative pain management, assessed using a visual analogue scale and fentanyl consumed in the first 24 h after surgery was noted. We found the prevalence of G118 allele was 31.3%. The A118G polymorphism had a gene-dose-dependent effect on electrical pain tolerance threshold. Fentanyl consumption was also significantly different in patients with different OPRM1 genotypes (homozygotes for 118G consumed more than did heterozygotes or homozygotes for 118A). Fentanyl consumption increased in accordance with the number of 118G alleles. We conclude that OPRM1 gene analysis may help predict individual opioid sensitivity and so optimise postoperative pain control.
本研究旨在探讨阿片受体μ1 基因（OPRM1）A118G 多态性对妇科患者痛觉敏感性和术后芬太尼用量的影响。采用电刺激法测定患者术前痛觉阈值和痛觉耐受阈。采用聚合酶链反应-限制性片段长度多态性方法检测 A118G 多态性。术后采用静脉芬太尼患者自控镇痛（PCIA），采用视觉模拟评分法（VAS）评估疼痛，并记录术后 24 h 内芬太尼的用量。结果发现，G118 等位基因的频率为 31.3%。A118G 多态性与电刺激痛觉耐受阈呈基因剂量依赖性。不同 OPRM1 基因型患者的芬太尼用量也存在显著差异（118G 纯合子患者芬太尼用量明显多于 118A 纯合子或杂合子患者）。芬太尼用量随 118G 等位基因数的增加而增加。结论：OPRM1 基因分析有助于预测个体阿片类药物敏感性，从而优化术后镇痛效果。
