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单核苷酸多态性是否影响小儿脊柱侧弯矫正手术后的疼痛强度和舒芬太尼镇痛效果?

Do Single-Nucleotide Polymorphisms Affect Pain Intensity and Sufentanil Analgesia After Pediatric Scoliosis Correction Surgery?

作者信息

Turczynowicz Aleksander, Równy Jakub, Przontka Weronika, Grzesik Magdalena, Jakubów Piotr, Kowalczuk Oksana

机构信息

Department of Anesthesiology and Intensive Care for Children and Adolescents with Postoperative and Pain Treatment Unit, Medical University of Bialystok, 15-274 Bialystok, Poland.

Institute of Psychology, University of Lodz, 90-128 Lodz, Poland.

出版信息

Int J Mol Sci. 2025 Apr 9;26(8):3504. doi: 10.3390/ijms26083504.

Abstract

Pain management in children remains a challenge. Postoperative pain assessment, which currently relies on behavioral and subjective scales, could be enhanced by the identification of single nucleotide polymorphisms effect on pain thresholds and opioid metabolism. This study explores the impact of nine SNPs-rs1799971, rs4680, rs4633, rs6269, rs4818 (with catechol-o-methyltransferase haplotypes), rs7832704, rs1801253, and rs1045642-on postoperative pain intensity, opioid requirements, coanalgesic use, C-reactive protein levels, and post-anesthesia care unit length of stay. This study involved 42 pediatric patients undergoing scoliosis correction surgery with postoperative sufentanil infusion. The genotyping was performed using real-time PCR with peripheral blood samples. Patients with the rs1801253 GG genotype showed significantly lower 24 h NRS pain ratings ( = 0.032) and lower sufentanil infusion rates at the level of statistical tendency ( = 0.093). Patients with the rs1205 CT genotype had a shorter PACU length of stay ( = 0.012). In contrast, those with the rs1045642 GG genotype had a longer PACU stay by 0.72 h ( = 0.046). No significant associations were found for rs1799971, , or SNPs. rs1801253may be a novel SNP indicating higher postoperative pain risk, while rs1205 and rs1045642 could predict increased care requirements in PACUs. The rs1801253 SNP may also predict opioid demand. These results suggest SNPs should be considered in acute pain assessment.

摘要

儿童疼痛管理仍然是一项挑战。目前依靠行为和主观量表进行的术后疼痛评估,可通过识别单核苷酸多态性对疼痛阈值和阿片类药物代谢的影响来加以改进。本研究探讨了9个单核苷酸多态性(SNPs)——rs1799971、rs4680、rs4633、rs6269、rs4818(与儿茶酚-O-甲基转移酶单倍型相关)、rs7832704、rs1801253和rs1045642——对术后疼痛强度、阿片类药物需求量、辅助镇痛药使用情况、C反应蛋白水平及麻醉后护理单元住院时间的影响。本研究纳入了42例接受脊柱侧弯矫正手术并在术后输注舒芬太尼的儿科患者。采用实时聚合酶链反应对外周血样本进行基因分型。rs1801253基因GG基因型的患者24小时数字评定量表(NRS)疼痛评分显著更低(P = 0.032),且在统计学趋势水平上舒芬太尼输注率更低(P = 0.093)。rs1205基因CT基因型的患者麻醉后护理单元(PACU)住院时间更短(P = 0.012)。相比之下,rs1045642基因GG基因型的患者PACU住院时间延长0.72小时(P = 0.046)。rs1799971、rs4680或其他SNPs未发现显著相关性。rs1801253可能是一个表明术后疼痛风险更高的新型SNP,而rs1205和rs1045642可预测PACU护理需求增加。rs1801253 SNP也可能预测阿片类药物需求量。这些结果表明,在急性疼痛评估中应考虑SNP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dda/12026534/c88ed16af9a7/ijms-26-03504-g001.jpg

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