Department of Anesthesiology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Department of Anesthesiology, Gusu School Nanjing Medical University, Suzhou, China.
Medicine (Baltimore). 2024 Apr 26;103(17):e37980. doi: 10.1097/MD.0000000000037980.
The aim of this observational study was to investigate the effects of catechol-O-methyltransferase (COMT) and ATP-binding cassette transporter B1 (ABCB1) gene polymorphisms on the postoperative analgesic effect of sufentanil in Chinese Han pediatric patients with fractures. A total of 185 pediatric patients who underwent fracture surgery were included. Polymerase chain reaction-restriction fragment length polymorphism was used to detect the polymorphisms of COMT and ABCB1 genes. Sufentanil was used for postoperative analgesia. The pain level of the patients was evaluated using the face, legs, activity, cry, and consolability scale before surgery, during awakening, at 2, 6, 12, and 24 hours after surgery. The postoperative Ramsay sedation score, sufentanil consumption, and incidence of adverse reactions were also recorded. Pediatric patients with different genotypes of ABCB1 and COMT showed no statistically significant differences in general data such as age, gender, weight, height, surgical duration, and American Society of Anesthesiologists classification (P > .05). There were no statistically significant differences in sedation scores after surgery between different genotypes of ABCB1 and COMT (P > .05). Among patients with CC genotype in ABCB1, the pain scores and total consumption of sufentanil at awakening, 2 and 6 hours after surgery were higher compared to TT and CT genotypes (P < .05), while there were no statistically significant differences between TT and CT genotypes (P > .05). Among patients with AA genotype in COMT, the pain scores and total consumption of sufentanil at awakening, 2, 6, 12, and 24 hours after surgery were higher compared to AG and GG genotypes (P < .05), while there were no statistically significant differences between AG and GG genotypes (P > .05). There were no statistically significant differences in adverse reactions between different genotypes of ABCB1 and COMT (P > .05). The polymorphisms of COMT gene rs4680 and ABCB1 gene rs1045642 are associated with the analgesic effect and consumption of sufentanil in pediatric patients after fracture surgery.
本观察性研究旨在探讨儿茶酚-O-甲基转移酶（COMT）和三磷酸腺苷结合盒转运蛋白 B1（ABCB1）基因多态性对中国汉族骨折患儿术后舒芬太尼镇痛效果的影响。共纳入 185 例行骨折手术的儿科患者。采用聚合酶链反应-限制性片段长度多态性检测 COMT 和 ABCB1 基因多态性。舒芬太尼用于术后镇痛。术前、苏醒时、术后 2、6、12 和 24 小时，采用面部、腿部、活动、哭闹和安慰评分评估患者疼痛程度。记录术后 Ramsay 镇静评分、舒芬太尼用量及不良反应发生率。不同 ABCB1 和 COMT 基因型的儿科患者在年龄、性别、体重、身高、手术时间和美国麻醉医师协会（ASA）分级等一般资料方面无统计学差异（P＞.05）。不同 ABCB1 和 COMT 基因型患者术后镇静评分无统计学差异（P＞.05）。ABCB1 中 CC 基因型患者苏醒时、术后 2 小时和 6 小时疼痛评分和舒芬太尼总用量均高于 TT 和 CT 基因型（P＜.05），而 TT 和 CT 基因型之间无统计学差异（P＞.05）。COMT 中 AA 基因型患者苏醒时、术后 2 小时、6 小时、12 小时和 24 小时疼痛评分和舒芬太尼总用量均高于 AG 和 GG 基因型（P＜.05），而 AG 和 GG 基因型之间无统计学差异（P＞.05）。ABCB1 和 COMT 不同基因型之间不良反应发生率无统计学差异（P＞.05）。COMT 基因 rs4680 和 ABCB1 基因 rs1045642 多态性与骨折术后儿科患者舒芬太尼的镇痛效果和用量有关。
