Role of CYP2D6 Polymorphisms in the Outcome of Postoperative Pain Treatment

Stefano Angelo Santini, Davide Seripa, Paola Latina, Andrea Fontana, Carolina Gravina, Monia Lattanzi, Maria Savino, Antonietta P. Gallo, Giuseppe Melchionda, Maurizio Margaglione, Massimiliano Copetti, Lazzaro Di Mauro, Francesco Panza, Antonio Greco, Alberto Pilotto

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: To investigate the role of CYP2D6 phenotype in the outcome of postoperative (PO) pain (POP) treatment. Design: Longitudinal cohort study. Open-label trial with post hoc analysis. Setting: General Hospital Surgery and Recovery Units. Patients: Ninety unrelated Caucasians submitted to abdominal/thoracic surgery. Interventions: Standard multimodal POP treatment including opioids (tramadol) and nonsteroidal anti-inflammatory drugs (ketoprofen) at different dosages and infusion rates according to the predicted mild, moderate, or severe POP. Outcome Measures: Pain (Numeric Rating Scale-NRS) and sedation (Ramsay Sedation Scale-RSS) up to 24 hours after surgery. By genotyping 16 CYP2D6 alleles, the four CYP2D6 phenotypes poor metabolizer (PM), intermediate metabolizers (IM), extensive metabolizers (EM) and ultrarapid metabolizers (UM) were predicted. Results: As compared with the CYP2D6-EM phenotype, in the early PO time (30 min) a higher RSS mean score in IM was observed (P=0.035). A suggestion towards higher mean score in PM (P=0.091) and a minor mean score in UM (P=0.091) was also detected. No difference in the outcome of pain across the CYP2D6 phenotypes was observed. Conclusions: In respect to the normal CYP2D6 phenotype, our results suggested that slowly metabolizers (IMs and PMs) might have a major sedation, whereas more rapid metabolizers (UM) a minor sedation, in the early time after surgery. A minor role of CYP2D6 phenotype in PO analgesia may be suggested.
Original languageEnglish
Pages (from-to)2012-2023
Number of pages12
JournalPain Medicine
Volume16
DOIs
Publication statusPublished - 2015

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics
  • CYP2D6
  • Cytochrome P-450 CYP2D6
  • Cytochrome P450
  • Female
  • Genetic Markers
  • Genetic Predisposition to Disease
  • Humans
  • Italy
  • Ketoprofen
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • POP
  • Pain Measurement
  • Pain, Postoperative
  • Pharmacogenetics
  • Polymorphism, Single Nucleotide
  • Postoperative Pain Treatment
  • Risk Factors
  • Tramadol
  • Treatment Outcome
  • Young Adult

Fingerprint

Dive into the research topics of 'Role of CYP2D6 Polymorphisms in the Outcome of Postoperative Pain Treatment'. Together they form a unique fingerprint.

Cite this