以及多态性：对心脏手术后急性、慢性和实验性疼痛的影响

and polymorphisms: implications on postoperative acute, chronic and experimental pain after cardiac surgery.

作者信息

Matic Maja, de Hoogd Sjoerd, de Wildt Saskia N, Tibboel Dick, Knibbe Catherijne Aj, van Schaik Ron Hn

机构信息

Department of Clinical Chemistry, Erasmus MC - University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands.

Intensive Care & Department of Paediatric Surgery, Erasmus MC - University Medical Center Rotterdam, Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands.

出版信息

Pharmacogenomics. 2020 Feb;21(3):181-193. doi: 10.2217/pgs-2019-0141.

DOI:10.2217/pgs-2019-0141

PMID:31967515

Abstract

Investigate the potential role of (mu-opioid receptor) and (catechol-O-methyltransferase enzyme) polymorphisms in postoperative acute, chronic and experimental thermal pain. A secondary analysis of 125 adult cardiac surgery patients that were randomized between fentanyl and remifentanil during surgery and genotyped. Patients in the fentanyl group with the high-pain sensitivity haplotype required less postoperative morphine compared with the average-pain sensitivity haplotype (19.4 [16.5; 23.0] vs 34.6 [26.2; 41.4]; p = 0.00768), but not to the low-pain sensitivity group (30.1 [19.1; 37.7]; p = 0.13). No association was found between haplotype and other pain outcomes or polymorphisms and the different pain modalities. haplotype appears to explain part of the variability in acute postoperative pain in adult cardiac surgery patients.

摘要

研究μ-阿片受体（mu-opioid receptor）和儿茶酚-O-甲基转移酶（catechol-O-methyltransferase enzyme）基因多态性在术后急性、慢性及实验性热痛中的潜在作用。对125例成年心脏手术患者进行二次分析，这些患者在手术期间被随机分为芬太尼组和瑞芬太尼组，并进行基因分型。与平均疼痛敏感性单倍型相比，芬太尼组中具有高疼痛敏感性单倍型的患者术后所需吗啡量更少（19.4 [16.5; 23.0] 对比 34.6 [26.2; 41.4]; p = 0.00768），但与低疼痛敏感性组相比无差异（30.1 [19.1; 37.7]; p = 0.13）。未发现单倍型与其他疼痛结局之间以及基因多态性与不同疼痛模式之间存在关联。单倍型似乎可以解释成年心脏手术患者术后急性疼痛变异性的部分原因。