Association Of CYP3A4 Gene Polymorphisms With Sufentanil Analgesic Effect

Objective: Study on the analgesic effect of CYP3A4*1G gene polymorphism in postoperative cervical carcinoma patients with sufentanil. To provide experimental and theoretical guidance for clinical individualized medication of sufentanil analgesia.Methods: 296 Stage I or II cervical cancer patients was scheduled to undergo total abdominal hysterectomy with pelvic lymph node dissection under general anesthesia were enrolled in this study, all the patients,BMI are in the normal range( 1+20%), having American Society of Anesthesiologists physical status of I or II, exclusion criteria: smoking, alcohol,kidney disease, liver disease, diabetes, cardiovascular disease, abnormal liver function, long term application of analgesics. All patients were approved by the Institutional Ethics Committee of the Affiliated Cancer Hospital of Xiangya Medical School,Central South University,China. Signed and informed consents were obtained from all patients.According to different testing results of CYP3A4 gene detected by PCR Technology, patients were divided into three genotypegroup of CYP3A4*1/*1,CYP3A4*1/*1G and CYP3A4*1G/*1G; and detecting the blood drug concentration after first minute and tenth minutes of sufentanil induced dose. All patients were treated with postoperative intravenous analgesia andrecorded withthe general situation, adverse reactions, sufentanil consumption, NRS score and the reaction degree of sedation at 0,8,24and48 h. Statistical analysis was performed by SPSS 19.0.Results:1.272 patients with cervical cancer operation were dividedinto three genotypegroups according the results of genetic testing, including 112 case of CYP3A4*1/*1genotype, 136 case of CYP3A4*1/*1Ggenotypeand 24 case of CYP3A4*1G/*1G. The mutation frequency of CYP3A4*1G allele in cervical cancer operation patients was 29.4%. 2. There was no statistically significant difference with the general situation, operation time and sufentanil consumption during operation in three groups of patients(p>0.05). 3.There was no statistically significant difference between the three group of blood drug concentration after first minute and tenth minutes of sufentanil induced dose(p>0.05). 4.The average consumption of postoperative sufentanil, NRS score and the reaction degree of sedation were have no statistically significant difference(p>0.05).Conclusion 1. The mutation frequency of CYP3A4*1G allele in cervical cancer operation patients was 29.4% in Chinese. 2.There was no statistically significant influence between the CYP3A4*1G gene polymorphism and blood drug concentration after first minute and tenth minutes of sufentanil induced dose. 3. The CYP3A4*1G gene polymorphism had no effect on the postoperative consumption of sufentanil,the reaction degree of sedation and postoperative analgesic effect in patients with cervical cancer.