Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, 111 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
Department of Pharmacy, Zhongshan Hospital, Fudan University, 111 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
BMC Anesthesiol. 2023 May 22;23(1):173. doi: 10.1186/s12871-023-02120-1.
This study was conducted to examine the association between the A118G polymorphism of the OPRM1 gene and the risk of increased VAS scores in patients with colorectal cancer who underwent laparoscopic radical resection for which fentanyl was used.
The OPRM1 A118G genotype in subjects were detected. The relationship between the A118G polymorphism of the OPRM1 gene and increased Visual Analogue Scale (VAS) scores throughout the perioperative period was explored. A total of 101 patients receiving fentanyl anesthesia undergoing laparoscopic radical resection of colon tumors at Zhongshan Hospital, Fudan University between July 2018 and December 2020 were investigated in the present study. The relative risk between the A118G polymorphism of the OPRM1 gene and VAS ≥ 4 in the PACU was estimated using the adjusted effect relationship diagram, baseline characteristic analysis, and multiple logistic regression analysis. The relationship between the A118G polymorphism of the OPRM1 gene and VAS in the PACU, as well as perioperative fentanyl usage, was examined after confounders were adjusted.
Subjects with OPRM1 A118G wild gene A were less sensitive to fentanyl, which was a risk factor for PACU VAS ≥ 4. Before the model was adjusted, the odds ratio (OR) was 14.73 (P = 0.001). After adjusting for age, sex, weight, height, and the duration of surgery, the OR increased to 16.55 (P = 0.001). When adjusting for age, sex, weight, height, surgery duration, COMT Val158Met gene polymorphism, CYP3A4 *1G gene polymorphism, and CYP3A5 *3gene polymorphism, the OR was 19.94 (P = 0.002). Moreover, OPRM1 A118G wild type gene A was found to be a risk factor for increased dosage of fentanyl in the PACU. Before the model was adjusted, the OR reached 16.90 (P = 0.0132). After adjusting for age, sex, body weight, intraoperative fentanyl dosage, surgery duration, and height, the OR was 13.81, (P = 0.0438). When adjusting for age, sex, weight, height, intraoperative fentanyl dosage, surgery duration, COMT Val158Met gene polymorphism, CYP3A4 *1G gene polymorphism, and CYP3A5 *3 gene polymorphism, the OR reached 15.23, (P = 0.0205).
The A118G polymorphism of the OPRM1 gene carrying wild gene A was a risk factor for VAS ≥ 4 in the PACU. Moreover, it is a risk factor for increased dosage of fentanyl in the PACU.
本研究旨在探讨 OPRM1 基因 A118G 多态性与接受芬太尼麻醉行腹腔镜结直肠肿瘤根治术患者围术期视觉模拟评分（VAS）升高的关系。
检测受试者 OPRM1 A118G 基因型，探讨 OPRM1 基因 A118G 多态性与整个围术期 VAS 升高的关系。本研究纳入了 2018 年 7 月至 2020 年 12 月在复旦大学附属中山医院接受芬太尼麻醉行腹腔镜结直肠肿瘤根治术的 101 例患者。采用调整效应关系图、基线特征分析和多因素逻辑回归分析，估计 OPRM1 基因 A118G 多态性与 PACU 中 VAS≥4 之间的相对风险。在调整混杂因素后，研究 OPRM1 基因 A118G 多态性与 PACU 中 VAS 及围术期芬太尼使用的关系。
携带 OPRM1 A118G 野生型基因 A 的患者对芬太尼的敏感性降低，是 PACU 中 VAS≥4 的危险因素。在未调整模型时，比值比（OR）为 14.73（P=0.001）。调整年龄、性别、体重、身高和手术时间后，OR 增加至 16.55（P=0.001）。调整年龄、性别、体重、身高、手术时间、COMT Val158Met 基因多态性、CYP3A41G 基因多态性和 CYP3A53 基因多态性后，OR 为 19.94（P=0.002）。此外，OPRM1 A118G 野生型基因 A 是 PACU 中芬太尼用量增加的危险因素。在未调整模型时，OR 达到 16.90（P=0.0132）。调整年龄、性别、体重、术中芬太尼用量、手术时间和身高后，OR 为 13.81（P=0.0438）。调整年龄、性别、体重、身高、术中芬太尼用量、手术时间、COMT Val158Met 基因多态性、CYP3A41G 基因多态性和 CYP3A53 基因多态性后，OR 达到 15.23（P=0.0205）。
携带 OPRM1 基因 A118G 野生型基因 A 是 PACU 中 VAS≥4 的危险因素，也是 PACU 中芬太尼用量增加的危险因素。
