Effects of COMT G472A genetic polymorphism on postoperative analgesia with fentanyl
10.3760/cma.j.issn.0254-1416.2011.09.002
- VernacularTitle:儿茶酚氧位甲基转移酶G472A基因多态性对病人芬太尼镇痛效应的影响
- Author:
Jie DENG
;
Min LI
;
Guozhong CHEN
;
Hongtao SONG
- Publication Type:Journal Article
- Keywords:
Catechol O-methyltransferase;
Polymorphism,single nucleotide;
Fentanyl;
Analgesia,patient-controlled
- From:
Chinese Journal of Anesthesiology
2011;31(9):1039-1041
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of COMT G472A genetic polymorphism on postoperative analgesia with fentanyl.Methods One hundred and twenty-nine ASA I or Ⅱ patients aged 19-71 yr undergoing operation on lumbar vertebrae under general anesthesia were enrolled in this study.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphism of COMT G472A.The patients were assigned into 2 groups according to their genotypes:wild group and mutation group.Pain was assessed using VAS after the patients regained consciousness.When VAS score ＞ 3,the patients were given fentanyl 20μg iv every 5 win until VAS score was decreased to ≤ 3.PCIA was then started.The PCIA solution contained fentanyl 20 μg/kg + flurbiprofenaxetil 150-250 mg or propacetamol 4-6 g in normal saline 75 ml.The patients received a background infusion of 1 ml/h after a loading dose of 3 ml.The PCIA pump was programmed to allow a 0.5 ml bolus with a 15 min lockout interval.The amount of fentan yl infused in 24 h and 48 h was recorded.The amount of flurbiprofen (1 mg=fentanyl 1 μg) or propacetamol (1 g =fentanyl 37.5 μg) was transformed into fentanyl.Results Significantly less fentanyl was consumed in 48 h in mutation group ( n =49) than in wild group ( n =80).Conclusion COMT G472A is a factor contributing to the individual variation in patient' s response to postoperative analgesia with fentanyl.
