Muradian A A, Sychev D A, Blagovestnov D A, Petrov D I, Skukin D S, Epifanova I P, Sozaeva Z A, Kachanova A A, Denisenko N P, Abdullaev S P, Grishina E A
Russian Medical Academy of Continuous Professional Education.
Sklifosovsky Research Institute of Emergency Medicine.
Ter Arkh. 2022 Jun 17;94(5):610-615. doi: 10.26442/00403660.2022.05.201495.
To evaluate the possible association of CYP2C8 gene polymorphisms with the clinical efficacy and safety of ketorolac in relation to postoperative pain.
The study included 107 patients after video laparoscopic cholecystectomy, who received ketorolac (30 mg 2.0 w/m 3 r/d) as postoperative pain relief. All patients were genotyped for CYP2C8. The pain syndrome was assessed using the visual analog scale, the McGill pain questionnaire. The profile of adverse reactions was assessed by the dynamics of red blood counts, as a possible trigger for the development of gastrointestinal bleeding according to the method of global assessment of triggers (Global Trigger Tool GTT).
According to visual analog scale data: in carriers of the genotype CYP2C83 (rs10509681) and CYP2C83 (rs11572080) after 12, 24, 36, 48 hours the intensity of pain syndrome is lower than in carriers of the wild type (p0.05). According to the McGill pain questionnaire, there were no statistically significant differences in pain intensity between the two groups.
In carriers of the genotype CYP2C83 (rs10509681) and CYP2C83 (rs11572080), the effectiveness of anesthesia with ketorolac is higher than in carriers of the wild type. Carriage of the genotype CYP2C83 (rs10509681) and CYP2C83 (rs10509681) does not affect the risk of developing adverse reactions after ketorolac anesthesia.
评估CYP2C8基因多态性与酮咯酸用于术后疼痛的临床疗效及安全性之间的可能关联。
该研究纳入了107例行电视腹腔镜胆囊切除术的患者,他们接受酮咯酸(30毫克,2.0体重/体表面积立方米,每日3次)以缓解术后疼痛。所有患者均进行了CYP2C8基因分型。使用视觉模拟量表、麦吉尔疼痛问卷评估疼痛综合征。根据全球触发因素评估方法(全球触发工具GTT),通过红细胞计数动态评估不良反应情况,红细胞计数可能是胃肠道出血发生的触发因素。
根据视觉模拟量表数据:在CYP2C83(rs10509681)和CYP2C83(rs11572080)基因型携带者中,术后12、24、36、48小时疼痛综合征的强度低于野生型携带者(p<0.05)。根据麦吉尔疼痛问卷,两组之间的疼痛强度无统计学显著差异。
在CYP2C83(rs10509681)和CYP2C83(rs11572080)基因型携带者中,酮咯酸麻醉的效果高于野生型携带者。CYP2C83(rs10509681)和CYP2C83(rs10509681)基因型的携带情况不影响酮咯酸麻醉后发生不良反应的风险。