OPRM1 A118G,COMT V158M,ABCB1 C3435T Genetic Variability And The Effect Of Postoperative Analgesia With Sufentanil

Objective: The injury of tissue and nerves in lobectomy can lead to postoperative pain and seriously affect the postoperative recovery,quality of life and even outcome of patients.However,there were significant differences in analgesic effect among individuals,which resulted in low postoperative analgesic satisfaction.Genetic factors may contribute to individual differences in analgesia.Gene polymorphism can affect the analgesic effect of patients by changing the pain threshold and drug metabolism.The purpose of this study is to evaluate the relationship between ?-opioid receptor gene A118G(OPRM1 A118G),catechol-O-methyltransferase V158M(COMT V158M)and ATP binding cassette subfamily B member 1 C3435T(ABCB1 C3435T)gene polymorphisms in patients and the sufentanil analgesia effect after lung lobectomy,to explore individualized analgesia treatment target genes.Methods: The research involved 100 patients from Qingdao university affiliated hospital during November 2017 to October 2018.The patients was going to have thoracoscope lung lobectomy under general anesthesia,aged 18 to 60 years,ASA ? or ?.The variations of OPRM1 A118 G,COMT V158 M and ABCB1 C3435 T were detected in all these patients.And they were divided into three groups according to genotypes in each gene: wild,heterozygote and mutant type.The analgesic effects,dosage of sufentanil and sleep quality and anxiety condition were compared between the three groups under PCA analgesia model.Results: The mutation frequency of OPRM1 A118 to G was 35.5%.The VAS score of OPRM1 A118 G homozygote GG patients after operation was significantly higher than that of wild type gene A carriers,and the consumption of sufentanil increased significantly.But there was no significant difference in sleep quality and anxiety condition in three groups.The frequency of COMT V158 mutating to M was 31.5%.The VAS score of COMT V158 M homozygous MM patients was significantly lower than that of wild type gene V carriers,and the consumption of sufentanil was significantly reduced.There was no significant difference in sleep quality and anxiety condition.The frequency of mutation from ABCB1 C3435 to T was 57.5%.The VAS score of ABCB1 C3435 T homozygote TT patients was significantly lower than that of wild type gene C carriers.Sufentanil consumption was significantly reduced.Anxiety score of homozygote TT patients was significantly lower than that of other two groups.Conclusion: The variations of OPRM1 A118 G,COMT V158 M and ABCB1 C3435 T genes can influence the postoperative pain sensitivity and the demand for analgesics.The demand for sufentanil was higher in OPRM1 A118 G homozygote GG carriers after operation,but decreased in COMT V158 M homozygote MM and ABCB1 C3435 T homozygote TT carriers.Only ABCB1 C3435 T was associated with anxiety condition.OPRM1 A118 G,COMT V158 M and ABCB1 C3435 T gene polymorphisms may be the mechanisms that account for the differences in postoperative analgesia.