Department of Anesthesiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
Minerva Anestesiol. 2011 Jan;77(1):33-9. Epub 2010 Dec 9.
Genetic polymorphisms of the μ-opioid receptor gene OPRM1 A118G have been shown to influence opioid efficacy. The association of the OPRM1 A118G genetic polymorphism with side effects, such as nausea and vomiting, caused by opioids during analgesia has not been well-represented by the literature . This study aimed to investigate whether the genetic polymorphism of OPRM1 A118G contributed to the variability in nausea and vomiting during fentanyl analgesia in patients undergoing total abdominal hysterectomy or myomectomy.
One hundred sixty-five women, of Han nationality, aged 20-50 yrs, of ASA I or II, and scheduled for elective total abdominal hysterectomy or myomectomy under general anesthesia were enrolled. Intravenous fentanyl, patient-controlled analgesia was provided postoperatively for pain control. The presence and scores of postoperative nausea and vomiting for 24 hours were recorded and measured using rating scales. Pain was measured with a visual analog scale, and fentanyl consumption over 24 hours was recorded, as well. Genotyping of the A118G allele was conducted by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and patients were divided into three groups according to their genotype.
The frequency of the A118G allele was 32.4% for the patients in this study. Patients homozygous for 118G required more fentanyl to achieve adequate pain relief compared with the other two patient groups (patients homozygous for 118A and heterozygous). However, there were no statistically significant differences among the frequencies and scores of nausea and vomiting.
OPRM1 A118G has no effect on the individual variation of postoperative nausea and vomiting, the side effects of fentanyl analgesia, in Chinese women undergoing gynecologic surgery.
μ-阿片受体基因 OPRM1 A118G 的遗传多态性已被证明会影响阿片类药物的疗效。OPRM1 A118G 遗传多态性与阿片类药物在镇痛期间引起的副作用（如恶心和呕吐）之间的关系，在文献中并没有得到很好的体现。本研究旨在探讨 OPRM1 A118G 基因多态性是否导致接受芬太尼镇痛的全子宫切除术或子宫肌瘤切除术患者的恶心和呕吐的变异性。
选择 165 名汉族、年龄 20-50 岁、ASA Ⅰ或Ⅱ级、择期全身麻醉下接受全子宫切除术或子宫肌瘤切除术的女性患者。术后给予静脉芬太尼，患者自控镇痛（PCA）以控制疼痛。采用评分量表记录并测量术后 24 小时内恶心和呕吐的发生情况和评分。采用视觉模拟评分法测量疼痛，记录 24 小时内芬太尼的消耗量。通过聚合酶链反应-限制性片段长度多态性（PCR-RFLP）对 A118G 等位基因进行基因分型，根据基因型将患者分为三组。
本研究中患者 A118G 等位基因的频率为 32.4%。与其他两组患者（118A 纯合子和杂合子）相比，118G 纯合子患者需要更多的芬太尼才能达到足够的疼痛缓解效果。然而，恶心和呕吐的频率和评分之间没有统计学差异。
OPRM1 A118G 对中国妇科手术女性患者芬太尼镇痛的术后恶心和呕吐的个体变异、副作用没有影响。
