Application Of Gene Polymorphism Detection And Imaging Evaluation In Spinal Scoliosis Surgery

Background and objective Opioid receptor agonist sufentanil is one of the most commonly used drugs in clinical anesthesia,but it has a dose related adverse reaction in the operation of scoliosis,which affects the clinical use of the drug.We included in the correlation analysis of 110 cases of spinal surgery patients with four different gene loci typing and between the imaging parameters and the dosage of sufentanil,whether there was a significant difference between different genotypes and verify the imaging parameters and opioid dosage.The present study provided the basis for the feasibility and further experimental prospective.This study collected,analyzed and summarized the clinical data,investigated the analgesic effect of sufentanil in scoliosis patients after operation and adverse reaction combined with the genome associated with opioids in patients with scoliosis analysis and imaging parameters of opioid receptor polymorphisms(single nucleotide polymorphism SNP),parameters of genotype and individual images.The present study also explored different patients with opioid dosage to provide reference for clinical individualized medication.Methods: We have analyzed by early data collection(n=110)to conclude that the opioid receptor gene SNP site has a significant effect on the intraoperative and postoperative analgesic maintenance of opioids.Prospective prospective controlled trial was conducted to explore their relationship and the individualized use of opioids in scoliosis surgery under combined effects.The specific method is to start 2ml from peripheral venous blood before operation in PCR using pyrosequencing to detect cytochrome P450 enzymes CPY3A4*1G.The degree of pain was assessed during the observation period after surgery.Each group of patients using sufentanil electronic analgesia pump for postoperative analgesia,2 hours,6 hours,12 hours,24 hours,48 hours of follow-up the patient's pain after operation,and the corresponding clinical score,and record the analgesia pump dose and adverse reactions,visual simulation(VAS score)..The imaging parameters included scoliosis,flexibility,Cobb angle(coronal,Cobb,angle,CCA),operative fusion segment,intraoperative osteotomy plan(SPO,PSO andVCR),and postoperative index(Cincinnati).Results: 1.The incidence rate of CYP3A4*1G gene polymorphism and sufentanil in postoperative VAS score,drug demand and related adverse reactions: in postoperative T6,T12 and T24 time point,GG group and GA group VAS was higher than that of AA group(P<0.05);intraoperative dose GG group,GA group was higher than that of AA group(P<0.05);GG group and GA group of respiratory depression was lower than that in AA group(P<0.05).2.There was significant difference in the Cobb angle between the scoliosis and the postoperative patients with sufentanil(P<0.05).Other imaging parameters are investigated in statistical study with Department of orthopedics colleagues.Conclusions: 1.The gene polymorphism of scoliosis surgery is related to the efficacy and adverse reactions of sufentanil.The CYP3A4*1G genotype should be taken into account when applying sufentanil,and the VAS score of AA type is lowest,requiring less sufentanil,the incidence of respiratory depression is increased.2.The imaging parameters of patients with scoliosis surgery are related to the effect of sufentanil.According to the different imaging parameters,scoliosis,flexibility and Cobb angle,individualized treatment plan can be achieved,which can achieve satisfactory clinical efficacy.